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.

Ascension Se Wisconsin Hospital, Inc (NPI 1427007384)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ascension Se Wisconsin Hospital, Inc
Address	5000 W Chambers St
City	Milwaukee
State	WI
ZIP	53210
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$94.4M
Medicare	$0

ASCENSION SE WISCONSIN HOSPITAL, INC is effectively a Medicaid-centric provider: there is no Medicare billing on file while total Medicaid revenue is $94.4M, and its taxonomy is General Acute Care Hospital. This payer mix indicates the provider’s reported commercial/Medicare footprint is either minimal or not captured in these datasets, making Medicaid the primary observed revenue stream.

Revenue is highly concentrated in a small set of codes: the top 3 Medicaid codes (99283, 99284, 96361) together account for 37.6% of the provider’s total Medicaid revenue. Individually those codes generate $9.9M (99283, 15.7%), $7.2M (99284, 11.5%), and $6.6M (96361, 10.4%), signaling that a few service lines drive a large share of receipts.

The code mix shows the hospital operates a very high-volume emergency department and acute infusion/rehydration service line: 99283 (150.2K claims, $66 avg paid/claim, $9.9M) and 99284 (120.8K claims, $60 avg paid/claim, $7.2M) are among the top revenue drivers, and infusion/IV hydration codes such as 96361 (45.3K claims, $145 avg paid/claim, $6.6M), 96365, and 96360 also contribute materially. These patterns are consistent with heavy ED throughput and frequent IV/infusion management for dehydration or acute care.

The provider performs unusually large volumes of infectious disease and lab testing, including high ranks on nucleic acid amplification tests: 87491 (56.9K claims, $39, $2.2M), 87591 (56.9K claims, $34, $1.9M), 87661 (49.6K claims, $32, $1.6M), 87635 (29.6K claims, $50, $1.5M) and U0003 (13.6K claims, $80, $1.1M). Multiple of these lab codes are listed as "extreme outlier" or notably above typical state volume, indicating a large onsite or associated lab operation supporting high throughput testing.

Rehabilitation and outpatient therapy are meaningful ancillary lines: 97110 (95.5K claims, $38, $3.6M) and 97140 (48.5K claims, $22, $1.1M) rank in the 100th and very high percentiles in-state, showing substantial physical therapy volume alongside acute care services. This suggests a mixed service model where both ED/acute care and outpatient therapy generate consistent Medicaid activity.

Obstetrics and diagnostic imaging appear as additional service strengths: 59025 (16.2K claims, $72, $1.2M) ranks #1 of 65 providers in-state (100th percentile) for fetal heart-rate testing, and CT head 70450 (18.1K claims, $79, $1.4M) is also well above typical volume. The #1 ranking on 59025 signals a notable obstetrics monitoring presence relative to peers.

State-level competitive standing is dominant across many Medicaid codes: several top codes rank in the 99th–100th percentiles (examples include 99283 at 99th, 99284 at 99th, 97110 at 100th, 97140 at 100th), and multiple descriptors characterize volumes as "extreme outlier" or "notably above typical." These high ranks indicate the provider is a major statewide player for emergency visits, certain lab tests, therapy services, and selected OB procedures in Medicaid.

The provider has a long-enumerated NPI (2006-05-09, ~20 years ago), indicating sustained operational tenure. Combined with the concentrated Medicaid revenue and high-volume service lines, this longevity supports the interpretation that the facility is a stable, established Medicaid-serving acute care hub for the region, which is relevant for payers evaluating network coverage and contracting exposure.

Medicaid: Complete Services Breakdown

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

532 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	150,190	$70	$9.9M
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.	120,810	$60	$7.2M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	45,320	$150	$6.6M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	57,440	$70	$3.9M
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.	66,690	$60	$3.7M
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…	95,530	$40	$3.6M
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…	47,480	$50	$2.6M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	56,880	$40	$2.2M
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.	95,480	$20	$2.1M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	56,880	$30	$1.9M

Showing 1–10 of 532

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Ascension Se Wisconsin Hospital, Inc — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

532 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1016	Case management, each 15 minutes	85	220	7,110	$70	$1.7M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	3	140	3,200	$160	$1.1M
P9016	Red blood cells, leukocytes reduced, each unit	5	10	750	$590	$906.4K
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.	3	360	1,550	$70	$614.4K
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.	5	430	760	$60	$484.6K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	9	20	320	$60	$483K
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.	6	190	1,790	$90	$390.9K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	19	40	150	$530	$381.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	5	140	2,200	$90	$358.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	11	10	40	$570	$357.5K

Showing 1–10 of 532

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	General Acute Care Hospital	$0	$18.7M
Saint Joseph Regional Medical Center- Plymouth Campus Inc	IN	General Acute Care Hospital	$0	$6.5M
Saint Joseph Regional Medical Center, Inc.	IN	Pulmonary Disease Physician	$0	$5.5M
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	Family Medicine Physician	$0	$4.8M
Douglas Liepert	IN	Sleep Medicine (Otolaryngology) Physician	$392K	$0
Eric Kim	CA	Neurology Physician	$300.8K	$0
Marcos Cruz	PR	Neurology Physician	$142.7K	$63.2K
Greg Schaublin	FL	Neurology Physician	$202.8K	$0
Vivian Hoang	TX	Neurology Physician	$191.6K	$0
Jonathan Mccrea	IN	Diagnostic Radiology Physician	$172K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Horizon Healthcare, Inc	WI	Multi-Specialty Clinic/Center	$0	$1.5M
Center For Pain Management, Sc	WI	Interventional Pain Medicine Physician	$0	$1.4M
Wisconsin Community Services, Inc-joshua Glover Rrc	WI	Substance Abuse Rehabilitation Facility	$0	$1.2M
Tahir Khan	WI	Podiatrist	$41.5K	$883.7K
Vipindas Chengat	WI	Internal Medicine Physician	$154.2K	$0
Nosheen Hasan	WI	Anesthesiology Physician	$66.3K	$0
Parag Panchal	WI	Anesthesiology Physician	$61.9K	$0
Michael Toye	WI	Physician Assistant	$60.1K	$0
Aditi Adhikari	WI	Family Nurse Practitioner	$41.8K	$0
Dana Wittenberg	WI	Clinical Social Worker	$34.9K	$0

Ascension Se Wisconsin Hospital, Inc — Billing Profile & Reimbursement Data

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Ascension Se Wisconsin Hospital, Inc — 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