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.

St. Cloud Hospital (NPI 1770532426)

St. Cloud Hospital is a clinic/center provider located in St Cloud, Minnesota. This profile covers 0 Medicare and 71 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	St. Cloud Hospital
Address	1555 Northway Drive
City	St Cloud
State	MN
ZIP	56303
Taxonomy	Clinic/Center
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

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

71 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…	28,180	$80	$2.1M
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…	22,630	$50	$1.1M
T1013	Sign language or oral interpretive services, per 15 minutes	9,160	$40	$384.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	9,240	$20	$147.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,210	$50	$59.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	4,990	$10	$54.8K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	2,540	$20	$53.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,750	$20	$49.6K
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…	780	$60	$46.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	660	$70	$45.5K

Showing 1–10 of 71

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

St. Cloud Hospital — 0 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

71 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	24	210	560	$60	$822.1K
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…	73	1,180	1,150	$80	$605.7K
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…	99	1,200	1,030	$70	$549.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	84	170	620	$40	$333K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	97	340	300	$100	$209.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	367	420	230	$90	$186.2K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	112	310	810	$30	$166.5K
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…	109	240	610	$70	$165.5K
X5622	N/A	138	300	470	$60	$159.8K
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…	103	200	720	$60	$155.4K

Showing 1–10 of 71

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Cloud Hospital	MN	General Acute Care Hospital	$0	$53.4M
St. Cloud Hospital	MN	Substance Use Disorder Rehabilitation Hospital Unit	$0	$5.2M
Minneapolis Clinic Of Neurology, Ltd	MN	Neurology Physician	$0	$5M
Sue Mandell	WA	Radiation Oncology Physician	$302.2K	$0
Hani Alkhatib	MN	Hematology & Oncology Physician	$173.1K	$0
Ramesh Kumar Tentu	MN	Hospitalist Physician	$171.8K	$0
Bradley Stish	MN	Radiation Oncology Physician	$171.7K	$0
John Dvorak	MN	Ophthalmology Physician	$160.8K	$0
Karan Shah	IL	Radiation Oncology Physician	$156.9K	$0
Christopher Miller	MN	Radiation Oncology Physician	$136.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Minnesota Mental Health Center	MN	Mental Health Counselor	$0	$36.2M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$20.8M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$19.3M
Eye Kraft Optical, Inc	MN	Eyewear Supplier	$0	$17.7M
Northway Academy, Inc.	MN	Developmental Disabilities Clinic/Center	$0	$14.4M
Koala Dental Care, LLC	MN	Pediatric Dentistry	$0	$11.3M
Centracare Health Systems	MN	Clinical Medical Laboratory	$1.2M	$9.4M
Centracare Health System	MN	Clinical Medical Laboratory	$345.1K	$9.1M
St. Cloud Area School District 742	MN	Local Education Agency (LEA)	$0	$9.3M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$6.9M

St. Cloud Hospital — Billing Profile & Reimbursement Data

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St. Cloud Hospital — 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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