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.

Aspirus Wausau Hospital, Inc. (NPI 1558363986)

Key Findings

Field	Value
Entity Type	Organization
Organization	Aspirus Wausau Hospital, Inc.
Address	333 Pine Ridge Blvd
City	Wausau
State	WI
ZIP	54401
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 15, 2005

Payer Source	Total Paid
Medicaid	$16.3M
Medicare	$0

ASPIRUS WAUSAU HOSPITAL, INC. appears to be effectively single‑payer in this dataset: there is no Medicare billing on file while total Medicaid revenue is $16.3M. The NPI was enumerated on 2005-08-15 (~21 years ago), confirming lengthy operational tenure but current billing in the available files is concentrated in Medicaid. This payer concentration means the facility’s visible financial footprint in our data is driven almost entirely by state Medicaid activity rather than Medicare participation.

Revenue concentration within Medicaid is meaningful: the precomputed top‑3 Medicaid codes account for 33.0% of the provider’s total Medicaid revenue. Those three codes are 96361 ($1.8M, 15.7% of Medicaid revenue), 99284 ($1M, 8.7%), and 99283 ($994.7K, 8.6%), indicating that a relatively small set of procedures makes up one third of all reported Medicaid receipts. This concentration elevates sensitivity to utilization or rate changes for these specific services.

The code mix signals an emergency‑department and acute inpatient focus. Several emergency E/M codes are among the highest revenue contributors — 99285 ($981.1K, 8.5%), 99284 ($1M, 8.7%), 99283 ($994.7K, 8.6%), and 99282 ($732.6K, 6.3%) — and the presence of G0463 (hospital outpatient clinic visits) alongside high counts of imaging codes supports a high ED and hospital outpatient throughput. Together these suggest that the hospital’s operations are driven by episodic acute care and emergency visits rather than, for example, elective ambulatory surgery or primarily outpatient specialty clinics.

Infusion and IV therapy comprise the single largest individual code: 96361 is the top Medicaid revenue code with 17.8K claims, $102 avg paid/claim and $1.8M in revenue (15.7% of Medicaid revenue). Complementary infusion codes 96360 ($384.3K) and 96365 ($310.9K) further show that IV fluid and infusion services (including treatment for dehydration and medication infusions) are a material part of the hospital’s care mix and revenue stream. This pattern is consistent with an ED and inpatient service line that frequently provides IV hydration and medication infusions.

Laboratory and infectious‑disease testing volumes are prominent and concentrated in a few high‑percentile codes: 87637 ($843.5K) ranks #4 of 77 in‑state (96th percentile), 87636 ($217K) ranks #4 of 85 (96th percentile), and C9803 ($239.1K) ranks #4 of 70 (96th percentile), while culture code 87070 ($180.4K) ranks #6 of 114 and is described as notably above typical state volume for this code. These signals point to substantial in‑house microbiology and molecular testing capacity (including multiplex respiratory panels and COVID specimen collection) that likely supports both ED and inpatient workflows.

The provider’s competitive standing across Medicaid is mixed but often strong in state context: several high‑acuity ED codes rank near the top of in‑state peers (for example 99285 ranks #19 of 331, 95th percentile), indicating above‑typical statewide presence for complex ED care. By contrast the single largest revenue code 96361, while still a top revenue driver, is described as “typical, unremarkable volume” in its peer group (ranks #11 of 135, 93th percentile), so the provider’s market position varies by service line rather than being uniformly dominant across all major codes.

Imaging and diagnostic services meaningfully support the clinical footprint: CT abdomen/pelvis 74177 ($314.2K, rank #25 of 223, 89th percentile), CT head 70450 ($285.8K, rank #28 of 221, 88th percentile), and transthoracic echo 93306 ($189.5K, rank #47 of 150, 69th percentile) are all in the top revenue list. These figures reinforce that the hospital operates substantial diagnostic radiology and cardiology testing capacity to support acute evaluations and emergency presentations.

Operational and reimbursement implications follow from payer and code concentration: because Medicaid accounts for all reported revenue ($16.3M) and the top three codes comprise 33.0% of Medicaid revenue, changes in Medicaid rates, prior‑authorization policies, or utilization management for infusion therapies and ED E/M services could materially affect revenue. Analysts and payers considering network strategy or reimbursement negotiations should weigh the hospital’s strong in‑state lab and high‑acuity ED volumes against its lack of reported Medicare activity in this file.

Medicaid: Complete Services Breakdown

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

353 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	17,800	$100	$1.8M
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.	19,870	$50	$1M
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.	16,310	$60	$994.7K
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.	22,300	$40	$981.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	8,610	$100	$843.5K
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.	47,550	$20	$760.7K
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.	11,820	$60	$732.6K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1,330	$300	$396.3K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	5,340	$70	$384.3K
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.	5,820	$50	$314.2K

Showing 1–10 of 353

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

Aspirus Wausau Hospital, Inc. — 4 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

353 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	11	140	3,200	$160	$1.1M
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…	11	20	760	$110	$1M
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.	50	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.	39	430	760	$60	$484.6K
G0482	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…	16	20	340	$90	$462K
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.	12	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.	6	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.	25	140	2,200	$90	$358.4K
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.	19	330	1,350	$60	$338K
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…	51	170	720	$70	$272.7K

Showing 1–10 of 353

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Aky Md, LLC	OK	Pediatrics Physician	$0	$42.2M
Aspirus Merrill Hospital & Clinics, Inc.	WI	Critical Access Hospital	$0	$11.1M
Aspirus Riverview Hospital & Clinics, Inc.	WI	General Acute Care Hospital	$0	$10.9M
Aspirus Wausau Hospital, Inc.	WI	Land Ambulance	$4M	$6.1M
Aspirus Wausau Hospital, Inc.	WI	Clinical Medical Laboratory	$0	$6.9M
Deepak Sambhara	WI	Ophthalmology Physician	$4.3M	$0
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
Aspirus Eagle River Hospital & Clinics, Inc.	WI	Critical Access Hospital	$0	$3.7M
Aspirus Vna Home Health Inc	WI	Inpatient Hospice	$0	$3.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
First Impressions Sc	WI	Pediatric Dentistry	$0	$17.3M
Healthfirst Network Inc. F/k/a Family Planning Health Services Inc.	WI	Non-Surgical Family Planning Clinic/Center	$0	$10.2M
Northwest Counseling & Guidance Clinic	WI	Adolescent and Children Mental Health Clinic/Center	$0	$3M
Aspirus Wausau Hospital, Inc	WI	Emergency Medicine Physician	$0	$2.7M
Aspirus Vna Home Health Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$2.4M
Total Renal Care Inc	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.4M
Mchs Hospitals Inc	WI	Internal Medicine Physician	$122.8K	$1.8M
Aspirus Wausau Hospital, Inc.	WI	Nephrology Physician	$0	$1.9M
Children's Service Society	WI	Professional Counselor	$0	$1.5M
Kristo, Ltc	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1.5M

Aspirus Wausau 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