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    OpenPayerNPI Medicare & MedicaidMercy Health Physicians Kentucky Specialty Care LL…
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    Mercy Health Physicians Kentucky Specialty Care LLC — Billing Profile & Reimbursement Data

    NPI 1700408093 · Paducah, KY · Surgery Physician

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    Mercy Health Physicians Kentucky Specialty Care LLC is a surgery physician provider located in Paducah, Kentucky. This profile covers 0 Medicare and 129 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMercy Health Physicians Kentucky Specialty Care LLC
    Address1530 Lone Oak Rd
    CityPaducah
    StateKY
    ZIP42003
    TaxonomySurgery Physician
    NPI EnumeratedMay 11, 2020

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.7M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    129 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The 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…52,650$30$1.4M
    99214The 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…29,320$40$1M
    99204The provider sees a new 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 provider…4,780$60$286.6K
    99203The 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…3,840$40$149.7K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.2,090$70$141.9K
    93010The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.18,580$10$130K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.10,450$10$115K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…1,400$80$114.8K
    87880The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.9,620$10$105.9K
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…2,880$30$98K

    Showing 1–10 of 129

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Kentucky median

    129 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    74177The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.1231801,870$280$1.5M
    74176The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.1541702,610$250$1M
    70450The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.1431802,960$110$672.4K
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…592101,340$160$568K
    93458In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…5660170$780$500.2K
    70553In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…76100440$320$477.2K
    90837In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…6801,270760$80$447.2K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.601701,300$230$441K
    78452In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…77130420$270$375.3K
    71275In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…103110780$170$354.8K

    Showing 1–10 of 129

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Mercy Health Physicians Kentucky Specialty Care LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mercy Health Physicians Kentucky LLCKYFamily Medicine Physician$0$11.9M
    Medical Foundation, Inc.MSGeriatric Medicine (Family Medicine) Physician$0$1.8M
    Shiraz PatelKYOrthopaedic Surgery Physician$318.9K$0
    Johnathan HaysVADiagnostic Radiology Physician$275K$32K
    Anil ManiKYInterventional Cardiology Physician$254.1K$0
    Ravi SharmaKYInterventional Cardiology Physician$246.8K$0
    Frederick DeweeseKYOrthopaedic Surgery Physician$235.2K$0
    Harikrishnan Damodaran NairKYInterventional Cardiology Physician$234.8K$0
    Timothy McdermottKYInterventional Cardiology Physician$221.7K$0
    Tarek AhdabILInterventional Cardiology Physician$198.8K$14K

    Nearby Providers

    Other providers in the same ZIP code as Mercy Health Physicians Kentucky Specialty Care LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Baptist Healthcare System, IncKYGeneral Acute Care Hospital$0$72.6M
    Mercy Health-lourdes Hospital LLCKYGeneral Acute Care Hospital$0$61.9M
    Baptist Health Medical Group IncKYFamily Medicine Physician$0$21.9M
    Ambulatory Surgery Center LLCKYAmbulatory Surgical Clinic/Center$771.4K$8.7M
    Joseph BlackmonKYMOHS-Micrographic Surgery Physician$6.9M$0
    John Colgan Jr.KYPediatric Dentistry$0$5.6M
    Justin ColganKYPediatric Dentistry$0$4.6M
    Paducah Ophthalmology Asc LLCKYAmbulatory Surgical Clinic/Center$1.3M$467.8K
    Halden FordKYDermatology Physician$1.3M$4.5K
    Lourdes Ambulatory Surgery Center LLCKYAmbulatory Surgical Clinic/Center$254.6K$596.4K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Kentucky Providers
    0 of 4 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Kentucky Distribution
    Mercy Health Physicians Kentucky Specialty Care LLC — 4 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky