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 Minnesota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Minnesota 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. Minnesota (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.

Regions Hospital (NPI 1629006457)

Field	Value
Entity Type	Organization
Organization	Regions Hospital
Address	640 Jackson St
City	Saint Paul
State	MN
ZIP	55101
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$44.4M
Medicare	$0

Key Findings

REGIONS HOSPITAL reports no Medicare billing on file and $44.4M in lifetime Medicaid revenue, making its observed payer footprint effectively single-payer Medicaid in the available data. This concentration means analyses of utilization and competitive standing should be interpreted in the context of Medicaid-dominated volume rather than a mixed Medicare/Medicaid profile.

Revenue is highly concentrated in three emergency department evaluation-and-management codes: 99285 ($15.7M, 35.8%), 99284 ($13.9M, 31.8%), and 99283 ($7.4M, 17.0%), which together account for 84.5% of the provider’s total Medicaid revenue. That preponderance of ED E/M revenue indicates that a very large share of the hospital’s Medicaid dollars flow through emergency services rather than outpatient specialties or elective procedural care.

The code mix indicates an ED-centric operational model: large claim counts for 99285 (40.2K claims), 99284 (56.7K claims), and 99283 (43.7K claims) point to very high ED throughput across acuity levels, while ancillary codes such as G0463 and G0378 show outpatient clinic and observation activity tied to that emergency workload. Supplemental high-volume services—like lab panels (80048), EKG recording (93005), and frequent rapid IV medication administration (96374)—support the interpretation that the facility operates as a high-throughput acute care hub with substantial in-ED diagnostics and interventions.

State-level competitive standing for core ED codes places the hospital among higher-volume peers but not an extreme outlier: 99285 ranks #9 of 160 providers in-state (95th percentile), 99284 ranks #9 of 206 (96th percentile), and 99283 ranks #11 of 218 (95th percentile). These percentiles indicate REGIONS HOSPITAL is a major ED provider in Minnesota by volume, delivering typical high volumes expected of a general acute care hospital rather than exhibiting anomalous billing behavior for these E/M codes.

Several procedure and testing codes are statistical outliers relative to in-state peers and highlight operational emphases outside basic ED E/M billing. 96374 is an extreme outlier (rank #1 of 89, 100th percentile) indicating unusually high use of rapid IV medication administrations; 80048 (rank #4 of 271, 99th percentile) and 93005 (rank #2 of 112, 99th percentile) are also extreme outliers, showing exceptionally high volumes of basic metabolic panels and 12‑lead EKGs compared with statewide norms.

Other codes appear notably above typical state volume and point to specialty testing or episodic services the hospital performs at scale: 0001A (3.5K claims, $60K revenue, rank #7 of 227, 97th percentile), 0002A (3.2K claims, $66.7K revenue, rank #8 of 209, 97th percentile), and 0241U (2.7K claims, $296.8K revenue, rank #6 of 112, 95th percentile) are all identified as notably above typical or high-percentile volumes, suggesting concentrated capacity in certain diagnostics or device-related services.

The NPI tenure (enumerated 2006-06-29, ~20 years ago) indicates an established presence in the market; when combined with the Medicaid-only revenue picture and ED-centric billing mix, this suggests a stable, long-standing acute care provider whose financial performance and utilization are heavily driven by emergency services and high-throughput diagnostics rather than diversified Medicare outpatient revenue streams.

Medicaid: Complete Services Breakdown

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

112 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	40,200	$390	$15.7M
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.	56,650	$250	$13.9M
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.	43,720	$170	$7.4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	24,000	$80	$2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	13,720	$120	$1.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	1,690	$310	$529.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	30,650	$10	$337.2K
0241U	N/A	2,750	$110	$296.8K
G0378	Hospital observation service, per hour	2,100	$130	$273.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	6,440	$40	$257.5K

Showing 1–10 of 112

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Regions Hospital — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

112 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	24	80	6,550	$80	$4.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	7	10	1,690	$300	$2.4M
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.	9	160	580	$170	$1.8M
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.	9	210	980	$140	$1.7M
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.	11	220	1,730	$120	$1.3M
A0428	Ambulance service, basic life support, non-emergency transport, (bls)	24	30	420	$220	$1.1M
A0425	Ground mileage, per statute mile	97	110	870	$80	$971K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	24	30	340	$60	$890.4K
T1013	Sign language or oral interpretive services, per 15 minutes	120	210	560	$60	$822.1K
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.	35	100	510	$40	$560.8K

Showing 1–10 of 112

Related Providers

Other providers that share a Tax Identification Number (TIN) with Regions Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Group Health, Inc.	MN	Multi-Specialty Clinic/Center	$0	$204M
Fairview Health Services	MN	General Acute Care Hospital	$0	$90.4M
Fairview Express Care	MN	Specialist	$0	$33.1M
Fairview Health Services	MN	General Acute Care Hospital	$0	$30M
Fairview Health Services	MN	Emergency Medicine Physician	$0	$26.6M
Saint Joseph Mercy Livingston Hospital	MI	General Acute Care Hospital	$0	$18.3M
Fairview Health Services	MN	General Acute Care Hospital	$0	$17.2M
Regions Hospital	MN	Emergency Medicine Physician	$0	$15.1M
Group Health, Inc.	MN	Multi-Specialty Clinic/Center	$0	$14.8M
Group Health, Inc.	MN	Clinical Medical Laboratory	$2.4M	$11.5M

Nearby Providers

Other providers in the same ZIP code as Regions Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ramsey County Community Human Services	MN	Public Health or Welfare Agency	$0	$97.5M
South Metro Human Services- Tcm	MN	Case Management Agency	$0	$21.3M
South Metro Human Services-act Purple	MN	Case Management Agency	$0	$10.9M
South Metro Human Services-act Blue	MN	Case Management Agency	$0	$9.9M
Specialized Treatment Services, Inc.	MN	Methadone Clinic	$444.6K	$6.4M
Gillette Children's Specialty Healthcare	MN	Multi-Specialty Clinic/Center	$0	$5.4M
Prasongchai Sattayaprasert	MN	Cardiovascular Disease Physician	$238.9K	$1.1K
Wilfrido Castaneda	MN	Diagnostic Radiology Physician	$151.2K	$0
Ryan Koene	MN	Clinical Cardiac Electrophysiology Physician	$120K	$0
Charles Shideman	MN	Radiation Oncology Physician	$118.9K	$0

Regions Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References