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NPI 1215101076 · Wausau, WI · Land Ambulance
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Aspirus Wausau Hospital, Inc. is a land ambulance provider located in Wausau, Wisconsin. This profile covers 9 Medicare and 12 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 | Aspirus Wausau Hospital, Inc. |
| Address | 333 Pine Ridge Blvd |
| City | Wausau |
| State | WI |
| ZIP | 54401 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | April 14, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.1M |
| Medicare | $4M |
ASPIRUS WAUSAU HOSPITAL, INC. operates as a land ambulance and aeromedical transport provider: the top revenue-driving codes are A0427 (ALS emergency transport), A0425 (ground mileage), and A0431 (rotary wing one-way transport), which together suggest a mixed operation of advanced-life-support ground responses and significant rotary-wing air transports. The presence of both high-volume mileage codes and high-average-paid air transport codes indicates this entity bills both mileage-based ground services and high-cost air transfers as core service lines.
Medicare revenue is highly concentrated in a few codes: the precomputed top-three Medicare codes account for 75.6% of this provider's total Medicare revenue, led by A0427, A0425, and A0431. This concentration means changes to reimbursement or utilization policies affecting these specific ambulance and mileage codes could materially affect Medicare revenue for the provider.
Medicaid billing is also concentrated but to a lesser degree: the top-three Medicaid codes account for 66.8% of total Medicaid revenue, with A0427, A0390, and A0425 driving most Medicaid dollars. Those codes reflect a similar service mix to Medicare (ALS and mileage-based billing), signaling consistent cross-payer reliance on mileage and advanced-life-support transports.
On payer mix, this provider reports $4M in total Medicare revenue and $6.1M in total Medicaid revenue, making Medicaid the larger single payer by reported dollars while Medicare remains a meaningful secondary revenue source. The dual-payer footprint indicates the operation serves both populations rather than being effectively single-payer dependent.
National competitive standing on Medicare is uneven: A0425 (ground mileage) is an extreme outlier — rank #86 of 8934 providers nationally at the 99th percentile — indicating unusually high national volume for mileage billing, while A0427 (ALS emergency) and A0431 (rotary wing) are described as typical, unremarkable volume despite high revenue shares. In short, the provider is nationally notable for mileage billing volume but otherwise participates at typical levels on other high-value ambulance codes.
In-state competitive standing on Medicaid shows strong positioning for ground and ALS-related codes: A0427 ranks #11 of 166 providers in-state (94th percentile) and A0425 ranks #11 of 158 providers in-state (94th percentile), while A0390 ranks #12 of 135 (92th percentile). By contrast, air-transport metrics such as A0431 and A0436 rank #4 of 6 providers in-state (40th percentile), so although air services generate substantial dollars, the state peer set is small and the provider is not a clear statewide leader for rotary-wing compared with its ground mileage dominance.
The provider has an established operating tenure: NPI enumerated 2008-04-14 (~18 years ago), which supports the interpretation that the current code mix and payer relationships reflect a mature service footprint rather than a nascent program. This longevity, combined with the concentrated code mix, suggests institutional experience in billing both high-volume mileage and advanced-life-support transports.
Operational and revenue risk is concentrated in mileage- and transport-focused codes: with 75.6% of Medicare revenue and 66.8% of Medicaid revenue coming from the top three codes, the provider is exposed to reimbursement or policy changes for A0427, A0425, A0431 (Medicare) and A0427, A0390, A0425 (Medicaid). Given the heavy weighting toward mileage and high-cost air transports, payers should expect that utilization shifts or rate adjustments for those specific codes would have outsized budgetary impact on this provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,660 | $420 | $1.1M |
| A0425 | Ground mileage, per statute mile | 134,650 | $10 | $1.1M |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 170 | $4,630 | $805.8K |
| A0436 | Rotary wing air mileage, per statute mile | 14,890 | $30 | $461.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 850 | $210 | $177.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 480 | $350 | $167.8K |
| A0433 | Advanced life support, level 2 (als 2) | 100 | $610 | $63.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 210 | $270 | $54.8K |
| A0434 | Specialty care transport (sct) | 60 | $720 | $41.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 9,700 | $190 | $1.8M |
| A0390 | Als mileage (per mile) | 5,850 | $240 | $1.4M |
| A0425 | Ground mileage, per statute mile | 9,200 | $90 | $828.4K |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 380 | $1,690 | $639.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,390 | $160 | $379.4K |
| A0436 | Rotary wing air mileage, per statute mile | 380 | $950 | $358.5K |
| A0380 | Bls mileage (per mile) | 1,860 | $130 | $246K |
| A0433 | Advanced life support, level 2 (als 2) | 490 | $330 | $160.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,460 | $50 | $110.8K |
| A0434 | Specialty care transport (sct) | 530 | $150 | $76.7K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 4 | 10 | 530 | $1,490 | $1.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 35 | 150 | 450 | $150 | $480.6K |
| A0436 | Rotary wing air mileage, per statute mile | 4 | 10 | 510 | $570 | $392.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 11 | 170 | 690 | $150 | $372.4K |
| A0434 | Specialty care transport (sct) | 5 | 20 | 80 | $260 | $242.7K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9 | 30 | 700 | $40 | $231.9K |
| A0433 | Advanced life support, level 2 (als 2) | 3 | 10 | 490 | $210 | $114.5K |
| A0380 | Bls mileage (per mile) | 28 | 110 | 290 | $30 | $113.7K |
| A0390 | Als mileage (per mile) | 12 | 140 | 440 | $50 | $103.4K |
| A0998 | Ambulance response and treatment, no transport | 46 | 50 | 180 | $60 | $70.4K |
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Other providers in the same ZIP code as Aspirus Wausau Hospital, Inc., ranked by combined Medicare and Medicaid revenue.
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