Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Wisconsin (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Mercy Health System Corporation (NPI 1598718603)

Mercy Health System Corporation is a multi-specialty clinic/center provider located in Janesville, Wisconsin. This profile covers 0 Medicare and 212 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Mercy Health System Corporation
Address	580 N Washington St
City	Janesville
State	WI
ZIP	53548
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$13.2M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

212 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	93,000	$40	$3.3M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	100,630	$30	$2.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	28,730	$20	$603.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,760	$60	$565.8K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	11,480	$40	$459K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,900	$60	$406.9K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	15,360	$30	$384.1K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	18,200	$20	$382.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	6,180	$40	$253.5K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	5,030	$50	$246.4K

Showing 1–10 of 212

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Mercy Health System Corporation — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

212 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	28	360	1,550	$70	$614.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	55	430	760	$60	$484.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	109	190	1,790	$90	$390.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	93	140	2,200	$90	$358.4K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	75	330	1,350	$60	$338K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	27	30	1,050	$70	$320.9K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	105	170	720	$70	$272.7K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	201	260	3,590	$20	$232.2K
J2357	Injection, omalizumab, 5 mg	5	10	370	$350	$228.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	99	190	620	$40	$226.6K

Showing 1–10 of 212

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward W Sparrow Hospital Association	MI	General Acute Care Hospital	$0	$126M
A2cl Services, LLC	WI	Clinical Medical Laboratory	$19M	$98.7M
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$107.9M
Christiana Care Health Services, Inc.	DE	General Acute Care Hospital	$0	$99.4M
Gundersen Lutheran Medical Center Inc	WI	General Acute Care Hospital	$0	$74.3M
Otero County Hospital Association	NM	General Acute Care Hospital	$0	$73.2M
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$55.1M
Nor-lea Hospital District	NM	Critical Access Hospital	$0	$53.2M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
St Vincent Hospital	NM	General Acute Care Hospital	$0	$46.5M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health System Corporation	WI	General Acute Care Hospital	$0	$25.4M
Mercy Health System Corporation	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.1M
Mercy Assisted Care, Inc	WI	Durable Medical Equipment & Medical Supplies	$0	$4M
School District Of Janesville	WI	Local Education Agency (LEA)	$0	$3.7M
City Of Janesville	WI	Land Ambulance	$702.3K	$2.1M
Trivium LLC	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.9M
Healthnet Of Rock County, Inc.	WI	Dentist	$0	$1.8M
Daleena Johnson	WI	Gerontology Nurse Practitioner	$160.5K	$285.1K
Imdad Ahmed	WI	Cardiovascular Disease Physician	$333.4K	$110
Shahid Shekhani	WI	Medical Oncology Physician	$200.7K	$0

Mercy Health System Corporation — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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