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

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

Wisconsin Specialty Surgery Center,llc (NPI 1053721530)

Field	Value
Entity Type	Organization
Organization	Wisconsin Specialty Surgery Center,llc
Address	7401 104th Ave Ste 100
City	Kenosha
State	WI
ZIP	53142
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	May 6, 2014

Payer Source	Total Paid
Medicare	$749.3K
Medicaid	$0

Key Findings

WISCONSIN SPECIALTY SURGERY CENTER,LLC presents as an ambulatory surgical clinic concentrated in orthopedic and spine-related services: its two largest revenue drivers are joint-replacement procedures (27130 and 27447) and it also bills heavily for image-guided spinal injections (e.g., 64483 and 62323). The mix of major arthroplasty codes alongside high-volume, lower-paid injection codes is consistent with a facility that performs both discrete high-reimbursement surgeries and throughput-driven pain intervention services in an outpatient setting.

Revenue is highly concentrated in a small set of Medicare codes: the precomputed top three Medicare codes account for 69.2% of this provider's total Medicare revenue, with 27130 contributing $227.3K (30.4%), 27447 contributing $216.8K (29.0%), and 64483 contributing $72.9K (9.8%). This concentration means the practice’s financial performance is materially dependent on continuing volumes for those specific joint-replacement and spinal injection services.

The provider’s payer mix is effectively single-payer Medicare at present: Total Medicare revenue is $749.3K and there is no Medicaid billing on file (Total Medicaid revenue: none). For analysts evaluating market exposure, this indicates reliance on Medicare reimbursement flows and little to no participation in Medicaid-managed care or state fee-for-service billing.

Competitive standing for the two principal arthroplasty codes is modest: 27130 (31 claims, $7333 avg paid/claim, ranks #3147 of 8062 nationally) sits near the middle of national peers (59th percentile), and 27447 (30 claims, $7227 avg paid/claim, ranks #6176 of 12089 nationally) is essentially typical among providers (47th percentile). These rankings suggest the center is not a dominant national provider of primary hip or knee replacement but operates at a routine volume level for those high-reimbursement procedures.

By contrast, the practice shows relatively strong national presence on several injection and minimally invasive pain procedures: 64483 ranks #990 of 8202 providers (88th percentile) and 62323 ranks #954 of 7397 providers (87th percentile), both described as above-typical volumes compared with peers. These elevated percentiles for spinal injection codes indicate the center is a comparatively active provider of image-guided injection services, which likely supports steady case volumes despite arthroplasty being only modest against national peers.

The procedure mix also includes a range of smaller orthopedic and hand procedures—64721 (carpal tunnel neuroplasty, $31.7K, 51 claims, 78th percentile), 28285 (hammertoe repair, $16.5K, 23 claims), and 26055 (trigger finger release, $14K, 30 claims)—signaling that the center manages both major joint cases and outpatient soft-tissue/hand/foot surgeries. This breadth suggests referral patterns that supply both elective joint arthroplasty cases and routine ambulatory orthopedic procedures, supporting diversified surgical throughput.

Operational tenure is established: the NPI was enumerated on 2014-05-06 (~12 years ago), which implies an ongoing presence in the market long enough to have developed referral relationships and procedure volume patterns reflected in the Medicare billing. Analysts should view current billing patterns as reflective of an established ambulatory orthopedic/pain practice rather than a very new entrant.

There are also low-volume or below-peer areas to note: codes such as G0260 (14 claims, ranks #957 of 967 nationally) sit near the bottom of national peers for that specific sacroiliac injection code, and other procedure ranks like 20680 (rank #447 of 601, 16th percentile) and 63047 (rank #2848 of 4170, 27th percentile) indicate limited presence for certain implant removal and lumbar decompression services. These lower rankings point to selective service lines where the center either does not compete heavily or refers these cases elsewhere, which may affect contracting or network considerations for payers.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	30	$7,330	$227.3K
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	30	$7,230	$216.8K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	220	$340	$72.9K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	160	$250	$39.7K
63047	The provider performs a laminectomy (excision of the thin bony plate at the back of a vertebra), facetectomy (excision of an area of a vertebra characterized by its smooth surface), and foraminotomy…	20	$2,420	$36.3K
64721	Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which…	50	$620	$31.7K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	80	$280	$22.8K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	40	$590	$20.6K
C9290	Injection, bupivacaine liposome, 1 mg	16,490	$1	$16.5K
28285	The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.	20	$720	$16.5K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Wisconsin Specialty Surgery Center,llc — 1 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	125	280	30	$990	$33.8K
27130	53	220	20	$970	$25.1K
28285	5	10	20	$390	$19.7K
G0260	23	20	50	$210	$16.8K
64635	51	130	30	$320	$12.3K
64721	11	80	30	$390	$12.3K
C9290	2	10	5,790	$1	$11.5K
64483	4	170	40	$160	$9.8K
26055	21	60	30	$280	$8.8K
63047	36	70	20	$490	$8.7K

Showing 1–10 of 17

Nearby Providers

Other providers in the same ZIP code as Wisconsin Specialty Surgery Center,llc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aurora Health Care Southern Lakes, Inc.	WI	General Acute Care Hospital	$0	$19.9M
Familia Dental Kenosha LLC	WI	Dental Clinic/Center	$0	$3.7M
Fresenius Medical Care Midwest Dialysis, LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.5M
Planned Parenthood Of Wi, Inc.	WI	Ambulatory Family Planning Facility	$0	$3.1M
Children's Medical Group	WI	Pediatrics Physician	$0	$2.6M
Children's Medical Group	WI	Pediatrics Physician	$0	$1.5M
Charleen Geissman	WI	Behavior Analyst	$0	$1.4M
Steven Kenzer	WI	Rheumatology Physician	$269.6K	$0
Eric Marsh	WI	Dermatology Physician	$256.1K	$0
Michael Slimack	WI	Adult Reconstructive Orthopaedic Surgery Physician	$211.2K	$0

Wisconsin Specialty Surgery Center,llc — Billing Profile & Reimbursement Data

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Wisconsin Specialty Surgery Center,llc — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References