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NPI 1932109675 · Milwaukee, WI · Clinical Medical Laboratory
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Wisconsin Diagnostic Laboratories LLC is a clinical medical laboratory provider located in Milwaukee, Wisconsin. This profile covers 305 Medicare and 253 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 | Wisconsin Diagnostic Laboratories LLC |
| Address | 9200 W Wisconsin Ave |
| City | Milwaukee |
| State | WI |
| ZIP | 53226 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $22.7M |
| Medicare | $2.3M |
Payer mix is heavily skewed toward Medicaid: this provider reports $22.7M in total Medicaid revenue compared with $2.3M in total Medicare revenue, indicating Medicaid is the dominant payer relationship for the lab. The scale difference suggests the organization functions primarily as an in‑state diagnostic services hub rather than a Medicare-focused national referral lab.
Revenue concentration differs by payer: the top 3 Medicare codes by revenue account for 18.7% of the provider's total Medicare revenue, while the top 3 Medicaid codes by revenue account for 44.1% of the provider's total Medicaid revenue. This contrast shows Medicare revenue is more dispersed across many small lab codes, whereas Medicaid revenue is substantially driven by a narrower set of high-volume tests.
Medicare top-line service mix points to routine outpatient chemistry and decentralized specimen collection: the leading Medicare codes are 82306 ($92.6K), 80053 ($88K), and P9603 ($82.8K), which together form the top three contributors cited above. The presence of vitamin D testing (82306) and comprehensive metabolic panels (80053) alongside a high-count travel/collection allowance code (P9603: 82.8K claims) suggests the lab conducts high-throughput clinical chemistry testing while also supporting large-scale specimen pickup from homebound or SNF populations.
Medicaid billing profile shows pronounced specialization in infectious disease and population screening: U0004 ($4.3M), 87491 ($1.6M), and 87591 ($1.5M) are the largest Medicaid revenue contributors and drive much of the Medicaid concentration reported above. High Medicaid volumes for COVID PCR (U0004), Chlamydia (87491), and Gonorrhea (87591) indicate the lab serves major public‑health and STI testing needs across the state.
Competitive standing differs by payer and code: on Medicare the provider posts many codes at high national percentiles but generally described as "typical, unremarkable volume" (for example 82306 ranks #172 of 12453, 80053 ranks #230 of 26416), indicating it is a solid national participant but not a dominant national leader for most Medicare tests. In contrast, several Medicaid code ranks mark the provider as a major in-state player — U0004 ranks #2 of 20 in-state (95th percentile; notably above typical state volume), 87491 ranks #2 of 156 (99th percentile; extreme outlier), and 87636 ranks #1 of 85 (100th percentile; extreme outlier) — consistent with outsized statewide market share for specific infectious disease assays.
Operational signal from claim counts and unit payments: some high-count codes have low per-claim payments on the Medicare side (P9603 shows 82.8K claims and $82.8K revenue, $1 avg paid/claim), which implies a business model that combines many low-reimbursement collection events with higher-reimbursement molecular and specialty assays. This mix can reflect an integrated specimen collection network feeding centralized high-complexity testing capacity.
Public‑health and specialty testing strengths are evident in Medicaid topology: the lab ranks #1 in-state for several higher-cost or specialized services including 87636 ($1.3M; 100th percentile; extreme outlier) and 81420 ($711.6K; ranked #1 in-state), and also posts extreme outlier volumes for tests such as 86481 (TB IGRA, $457.1K) and 83655 (lead testing, $327.3K). These data indicate the provider is a go-to source in Wisconsin for both high-throughput molecular infectious disease testing and selected population screening services.
Established presence and longevity reinforce market role: the NPI was enumerated on 2005-07-22 (~21 years ago), demonstrating a long tenure in the market. Coupled with the strong Medicaid footprint and code-level outlier status on multiple in-state assays, the history implies an entrenched relationship with Wisconsin public health programs and Medicaid payer channels.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
305 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 3,190 | $30 | $92.6K |
| 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. | 8,800 | $10 | $88K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 82,830 | $1 | $82.8K |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 1,900 | $40 | $76.2K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 4,620 | $20 | $74K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 9,120 | $10 | $72.9K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 8,950 | $10 | $71.6K |
| 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… | 8,710 | $10 | $69.7K |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 6,720 | $10 | $67.2K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 5,080 | $10 | $66K |
Showing 1–10 of 305
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 305 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.
253 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 58,530 | $70 | $4.3M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 57,940 | $30 | $1.6M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 52,930 | $30 | $1.5M |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 14,060 | $90 | $1.3M |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 29,260 | $30 | $731.4K |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 1,610 | $440 | $711.6K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 27,270 | $20 | $518.1K |
| 86481 | The lab analyst performs a test to evaluate an antigen response to certain tuberculosis (TB) antibodies by enumerating T cells that produce gamma interferon. | 6,820 | $70 | $457.1K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 43,880 | $10 | $438.8K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 5,940 | $70 | $427.6K |
Showing 1–10 of 253
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
253 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2 | 20 | 320 | $60 | $483K |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 1 | 10 | 570 | $400 | $269.3K |
| 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)… | 11 | 80 | 650 | $110 | $244.4K |
| 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. | 17 | 260 | 3,590 | $20 | $232.2K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 30 | 190 | 620 | $40 | $226.6K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 2 | 160 | 990 | $30 | $191.8K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 5 | 60 | 970 | $30 | $180.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 3 | 160 | 970 | $30 | $174.2K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 17 | 40 | 3,060 | $20 | $147.8K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 11 | 220 | 2,770 | $20 | $120.2K |
Showing 1–10 of 253
Other providers in the same ZIP code as Wisconsin Diagnostic Laboratories LLC, ranked by combined Medicare and Medicaid revenue.
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