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NPI 1932154705 · Twin Falls, ID · General Acute Care Hospital
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St. Luke's Magic Valley Regional Medical Center, Ltd. is a general acute care hospital provider located in Twin Falls, Idaho. This profile covers 0 Medicare and 320 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | St. Luke's Magic Valley Regional Medical Center, Ltd. |
| Address | 801 Pole Line Rd W |
| City | Twin Falls |
| State | ID |
| ZIP | 83301 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | May 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.9M |
| Medicare | $0 |
This facility is effectively a Medicaid-focused provider: there is no Medicare billing on file while total Medicaid revenue is $7.9M, making Medicaid the sole measurable payer in the dataset and indicating the provider operates primarily in a Medicaid-financed care stream. Analysts should treat this profile as single‑payer (Medicaid) when assessing revenue risk and payer mix dynamics.
Revenue is concentrated in a small number of high-dollar services: the top three Medicaid codes—92507 ($807.8K, 15.5%), 42820 ($700.6K, 13.5%), and G0463 ($530.7K, 10.2%)—account for 39.2% of the provider’s total Medicaid revenue. This concentration suggests financial sensitivity to volumes in speech/hearing services, pediatric ENT surgery, and hospital outpatient clinic visits.
G0463 (hospital outpatient clinic visit) shows exceptionally high utilization for a provider of this size: 59K claims, $9 avg paid/claim, and it ranks #2 of 21 providers in-state (95th percentile; notably above typical state volume). That pattern points to a substantial ambulatory clinic footprint and positions the hospital as a major outpatient access point for Medicaid patients in the region.
The surgical and pediatric ENT mix is notable: 42820 (tonsil/adenoid removal in patients <12) generated $700.6K (13.5%) with 363 claims and ranks #4 of 21 (85th percentile), and 69436 (tympanostomy) added $145.2K (2.8%). Together these codes indicate an active pediatric surgical service line and operating-room throughput tied to ENT procedures.
Speech, swallowing, and audiology services are material revenue drivers. 92507 alone produced $807.8K (15.5%) across 13.5K claims and 92523/92526 also appear on the top list, which, together with ENT procedures, shows an integrated continuum of diagnostic and therapeutic speech/hearing services in the hospital’s service mix.
The provider is a clear state-level leader on several diagnostic and screening services: 87804 (influenza immunoassay) is an extreme outlier at rank #1 of 83 providers in-state (100th percentile) with $89.3K revenue, while 80053 (CMP) and 85025 (CBC) are at the 96th and 98th percentiles respectively. High ranks for 76805 (obstetric ultrasound, #2 of 37, 97th percentile) and imaging codes such as 74177 and 70450 further indicate strong diagnostic throughput and laboratory volume relative to in-state peers.
Competitive standing is mixed by service line: the hospital is a dominant or leading statewide provider for several high-throughput diagnostics and outpatient visit codes (G0463, 87804, 76805, CMP/CBC panels), but for its largest single-revenue procedural codes like 92507 and 42820 it ranks in the upper-middle tier (84th–85th percentiles), representing solid but not exclusive market share in those specialized services.
The provider has long tenure in the NPI registry (NPI enumerated 2006-05-23, ~20 years ago), which, combined with the concentrated Medicaid revenue and broad outpatient/diagnostic volumes, suggests an established regional hospital with enduring Medicaid-facing ambulatory, diagnostic, and pediatric/ENT service lines.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
320 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92507 | The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with… | 13,460 | $60 | $807.8K |
| 42820 | The provider removes the tonsils and adenoids in a patient younger than 12 years old. | 360 | $1,930 | $700.6K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 58,970 | $10 | $530.7K |
| 97530 | The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity. | 7,080 | $70 | $466.9K |
| 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. | 2,580 | $140 | $353.5K |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 310 | $970 | $304.3K |
| 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. | 27,560 | $10 | $165.4K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 37,070 | $1 | $148.3K |
| 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… | 2,550 | $60 | $148.1K |
| 69436 | This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia. | 150 | $940 | $145.2K |
Showing 1–10 of 320
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
320 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 12 | 20 | 500 | $820 | $662.5K |
| G0483 | 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… | 4 | 10 | 590 | $210 | $598.8K |
| 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. | 26 | 60 | 1,080 | $110 | $595.5K |
| 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. | 29 | 80 | 1,020 | $90 | $502.7K |
| 97530 | The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity. | 58 | 280 | 1,480 | $70 | $389.4K |
| 92507 | The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with… | 35 | 210 | 3,020 | $50 | $389K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 5 | 10 | 300 | $510 | $359.7K |
| 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. | 27 | 80 | 880 | $70 | $265.5K |
| 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. | 11 | 40 | 530 | $70 | $237.8K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 2 | 20 | 4,340 | $10 | $236.8K |
Showing 1–10 of 320
Other providers in the same ZIP code as St. Luke's Magic Valley Regional Medical Center, Ltd., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Homestyle Direct LLC. | ID | Home Delivered Meals | $0 | $65.4M |
| St Luke's Clinic LLC | ID | Family Medicine Physician | $0 | $39.5M |
| Primary Therapy Source, LLC | ID | Physical Therapist | $0 | $11.7M |
| Wright Physical Therapy Limited Partnership | ID | Physical Therapist | $0 | $8.8M |
| Smiles 4 Kids, LLC | ID | Pediatric Dentistry | $0 | $8.7M |
| Family Health Services Corporation | ID | Federally Qualified Health Center (FQHC) | $0 | $8.1M |
| Twin Falls School District #411 | ID | Local Education Agency (LEA) | $0 | $6.6M |
| Sunshine Therapy LLC | ID | Behavior Analyst | $0 | $5.7M |
| Magic Valley Paramedics L L C | ID | Land Ambulance | $976.6K | $4.6M |
| Twin Falls Senior Living LLC | ID | Assisted Living Facility | $0 | $4.6M |
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