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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 Partners (NPI 1831132133)

Field	Value
Entity Type	Organization
Organization	Mercy Health Partners
Address	1500 E Sherman Blvd
City	Muskegon
State	MI
ZIP	49444
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 14, 2006

Payer Source	Total Paid
Medicaid	$98.1M
Medicare	$0

Key Findings

This provider is effectively single-payer in scope: there is no Medicare billing on file and total Medicaid revenue is $98.1M, indicating Medicaid drives the entirety of reported public-payer activity. The absence of Medicare billing combined with a Medicaid-focused revenue base suggests operations and contracting are concentrated on state programs rather than Medicare fee schedules. The NPI was enumerated 2006-06-14 (~20 years ago), reflecting an established presence in the market that has built up primarily Medicaid-facing relationships over time.

Revenue is highly concentrated in a small set of outpatient and emergency visit codes: the top three Medicaid codes (99285, G0463, 99284) account for 52.3% of the provider's total Medicaid revenue. Specifically, 99285 accounts for $14M (19.4%), G0463 for $13.2M (18.3%), and 99284 for $10.5M (14.6%), which indicates a business mix weighted toward acute evaluation-and-management services in both the emergency department and hospital outpatient clinic settings.

The code mix points to a high-volume emergency department and outpatient clinic operation. High-acuity ED visits are represented by 99285 (48.3K claims, $290 avg paid/claim, $14M revenue) and 99284 (56.4K claims, $186 avg paid/claim, $10.5M revenue), while G0463 (226.9K claims, $58 avg paid/claim, $13.2M revenue) reflects extensive hospital outpatient clinic activity; together these suggest the provider prioritizes urgent and ambulatory acute care pathways.

Ancillary and diagnostic services support the acute care footprint: imaging and procedure codes such as 74177 (12.2K claims, $137 avg paid/claim, $1.7M revenue), 70450 (13.8K claims, $91 avg paid/claim, $1.3M revenue), and chest radiography 71046 (38.6K claims, $36 avg paid/claim, $1.4M revenue) appear throughout the top code list. Gastrointestinal procedures also contribute meaningful revenue (43239: 3.9K claims, $326 avg paid/claim, $1.3M revenue; 45380: 2.1K claims, $482 avg paid/claim, $993.4K revenue), consistent with a full-service hospital supporting both ED and elective procedural care.

Infusion and medication administration are notable revenue streams: 96374 (44.1K claims, $96 avg paid/claim, $4.2M revenue) is high-volume and ranked #6 of 148 providers in-state (97th percentile; notably above typical state volume), and specialty drug billing such as J3380 (401 claims, $3114 avg paid/claim, $1.2M revenue) indicates the facility administers high-cost biologic infusions. Multiple additional administration codes (96365, 96375, 96361) appear in the top 25, reinforcing significant IV/infusion service capacity.

State-level competitive standing is strong in emergency and outpatient visit lines but mixed across other services. For core ED codes the provider ranks in high state percentiles—99285 ranks #35 of 404 (92th percentile; typical, unremarkable volume), 99284 ranks #32 of 477 (93th percentile; typical, unremarkable volume), and 99283 ranks #20 of 447 (96th percentile; notably above typical state volume)—while G0463 ranks #11 of 153 (93th percentile; typical, unremarkable volume), indicating above-average but not dominant positioning across these categories.

There are clear statistical outliers by the plain-English labels provided: several administration and ED codes are described as "notably above typical state volume" (for example 96374 at the 97th percentile and 99283 at the 96th percentile), which signals localized specialization or higher throughput in IV medication delivery and certain ED acuity levels. Conversely, some high-rank entries like G0381 are listed as top-ranked in a very small peer set (1 of 3, 100th percentile) but still labeled "typical, unremarkable volume," highlighting that rank must be interpreted alongside peer-set size and the supplied label.

Operationally, the mix of high counts for lower-acuity imaging and therapeutic exercise (97110: 52.8K claims, $25 avg paid/claim, $1.3M revenue; 71046: 38.6K claims) together with high-acuity ED throughput suggests the provider operates both high-volume basic diagnostic/rehab services and a busy emergency stream. For payer strategy and network planning, these patterns imply the facility is a critical Medicaid access point for urgent care, imaging, infusion therapies, and GI/endoscopy services within its Michigan market.

Medicaid: Complete Services Breakdown

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

674 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.	48,290	$290	$14M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	226,890	$60	$13.2M
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.	56,360	$190	$10.5M
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.	70,800	$120	$8.6M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	44,130	$100	$4.2M
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…	31,630	$60	$1.9M
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.	24,860	$70	$1.8M
74177	The 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.	12,200	$140	$1.7M
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…	38,610	$40	$1.4M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	52,790	$30	$1.3M

Showing 1–10 of 674

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Mercy Health Partners — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

674 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	11	150	5,330	$50	$2.8M
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.	35	400	1,510	$190	$2.6M
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.	32	480	1,350	$110	$1.7M
J3380	Injection, vedolizumab, intravenous, 1 mg	2	10	360	$2,850	$1.6M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	9	10	440	$970	$1.4M
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.	20	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	42	100	2,820	$180	$1.1M
J2357	Injection, omalizumab, 5 mg	10	10	450	$720	$1M
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	12	10	1,300	$90	$968.7K

Showing 1–10 of 674

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health Partners	MI	Critical Access Hospital	$0	$8M
April Rosalez	MI	Family Medicine Physician	$99.7K	$0
Courtney Garlick	MI	Diagnostic Radiology Physician	$90.3K	$0
Conrad Kozlowski	MI	Sleep Medicine (Internal Medicine) Physician	$50K	$0
Rickie Edgar	MI	Neurological Surgery Physician	$43.3K	$0
Louis Nykamp	MI	Psychiatry Physician	$33.1K	$0
Denise Gregory	MI	Psychiatry Physician	$23.2K	$0

Nearby Providers

Other providers in the same ZIP code as Mercy Health Partners, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moka Corporation	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$126.2M
Senior Resources Of West Michigan	MI	Case Management Agency	$0	$31.5M
Mgh Family Health Center	MI	Federally Qualified Health Center (FQHC)	$0	$24.4M
Hackley Community Care Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$23.1M
Orthopaedic Associates Of Muskegon, PC	MI	Orthopaedic Surgery Physician	$0	$7.1M
Port City Pediatrics	MI	Pediatrics Physician	$0	$5.9M
Radiology Muskegon PC	MI	Diagnostic Radiology Physician	$0	$5.9M
Mercy Specialty Services	MI	Internal Medicine Physician	$0	$5.3M
Paul Raphaelian	MI	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Muskegon Sc, LLC	MI	Ambulatory Surgical Clinic/Center	$967.6K	$68.1K

Mercy Health Partners — 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