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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. States
  3. Wisconsin

Wisconsin Medicare Spending

Medicare provider payments and utilization data for Wisconsin (WI)

🔎 Data Analysis

Wisconsin received $11.0B in total Medicare provider payments across 10 years of data.

The top specialty by spending is Clinical Laboratory, accounting for $330.1M in payments across 25 providers.

In 2023, 24.4K providers were actively billing Medicare in Wisconsin.

Annual Medicare spending grew 36% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

⚠️

2 AI-Flagged Providers in Wisconsin

Providers in this state flagged by the ML v2 fraud detection model

Edward CooneyInternal Medicine
90.6%
Sumit VermaFamily Practice
88.1%
View all ML-flagged providers →
Total Payments (10yr)
$11.0B
+4.9% vs 2022
Active Providers (2023)
24.4K
25.8M services
Top Specialty
Clinical Laboratory
$330.1M total
Specialties
30
$51.3K per provider

Spending Trends (2014-2023)

Year-over-Year Breakdown

YearPaymentsServicesProvidersYoY Change
2014$919.3M25.9M20.5K—
2015$961.8M26.0M21.0K+4.6%
2016$999.6M26.4M21.5K+3.9%
2017$1.1B27.0M22.2K+6.5%
2018$1.1B26.9M22.7K+5.7%
2019$1.2B26.7M23.3K+6.2%
2020$1.0B23.4M22.8K-13.3%
2021$1.2B26.0M23.5K+17.2%
2022$1.2B25.2M23.9K-1.7%
2023$1.3B25.8M24.4K+4.9%

Top Providers in Wisconsin

#ProviderSpecialtyPaymentsServices
1Exact Sciences Laboratories, LlcClinical Laboratory$299.3M600.4K
2Jeffrey WeberGastroenterology$20.8M1.0M
3A2cl Services, LlcClinical Laboratory$19.0M1.5M
4Bell Ambulance, Inc.Ambulance Service Provider$5.9M158.1K
5Nicholas TosiOphthalmology$4.9M42.0K
6Deepak SambharaOphthalmology$4.3M94.6K
7Aspirus Wausau Hospital, IncAmbulance Service Provider$4.0M154.1K
8Madison Surgery Center, Inc.Ambulatory Surgical Center$3.6M5.4K
9Sharath RajaOphthalmology$3.3M33.2K
10Superior Air-Ground Ambulance Services Of Wisconsin, IncAmbulance Service Provider$3.1M141.4K
11Jeffrey BahrInternal Medicine$3.1M269.2K
12Wisconsin Diagnostic Laboratories LlcClinical Laboratory$2.3M234.3K
13Amol KulkarniOphthalmology$2.1M17.8K
14City Of MadisonAmbulance Service Provider$2.0M30.9K
15Orthopedic Surgery Center Of Green Bay, LlcAmbulatory Surgical Center$2.0M428
16Dean Health Systems, Inc.Ambulatory Surgical Center$2.0M9.1K
17Douglas HempelRheumatology$1.9M144.1K
18Khalid KahookOphthalmology$1.8M15.8K
19Debbie LimRheumatology$1.8M124.1K
20Dean Health Systems, Inc.Ambulatory Surgical Center$1.8M1.9K
21Kelli HutchensPathology$1.7M47.6K
22Michael PossinOphthalmology$1.7M14.0K
23Lee HoferOphthalmology$1.7M14.7K
24Beta Diagnostic Labs LlcClinical Laboratory$1.7M36.1K
25Pharos Enterprises Of Wisconsin, LlcAmbulatory Surgical Center$1.7M3.3K

Most Billed Procedures in Wisconsin

CodeDescriptionPaymentsServicesProviders
81528Gene analysis (colorectal cancer)$299.3M600.4K1
99214Established patient office or other outpatient visit, 30-39 minutes$90.6M1.2M9.8K
99213Established patient office or other outpatient visit, 20-29 minutes$43.8M854.4K9.4K
J0178Injection, aflibercept, 1 mg$29.8M43.4K61
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$25.1M434.1K3.5K
A0427Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)$22.3M57.2K218
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$21.5M179.6K2.4K
99215Established patient office or other outpatient visit, 40-54 minutes$21.0M198.8K3.3K
66984Removal of cataract with insertion of prosthetic lens$20.7M383.2K312
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$18.4M208.5K2.1K
99285Emergency department visit with high level of medical decision making$16.4M128.5K1.2K
A0429Ambulance service, basic life support, emergency transport (bls-emergency)$15.8M48.1K301
88305Pathology examination of tissue using a microscope, intermediate complexity$13.5M378.8K301
91322Sarscov2 vac 50 mcg/0.5ml im$13.2M94.4K752
A0425Ground mileage, per statute mile$13.1M1.7M322
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$12.7M100.4K2.1K
99204New patient office or other outpatient visit, 45-59 minutes$12.4M121.3K3.4K
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$10.2M581.7K1.5K
99291Critical care, first 30-74 minutes$10.0M63.4K1.2K
98941Chiropractic manipulative treatment, 3-4 spinal regions$10.0M375.8K1.0K

Spending by Specialty

SpecialtyPaymentsProvidersAvg per Provider
Clinical Laboratory$330.1M25$13.2M
Ophthalmology$81.1M303$267.8K
Family Practice$64.3M2.0K$31.7K
Ambulance Service Provider$62.8M323$194.3K
Internal Medicine$62.1M1.2K$49.8K
Nurse Practitioner$56.8M3.6K$15.6K
Diagnostic Radiology$48.5M732$66.3K
Ambulatory Surgical Center$42.9M77$556.6K
Physician Assistant$31.5M2.4K$13.4K
Gastroenterology$30.8M246$125.1K
Physical Therapist in Private Practice$28.9M1.4K$20.6K
Dermatology$25.7M217$118.3K
Emergency Medicine$25.4M893$28.4K
Mass Immunizer Roster Biller$22.4M506$44.3K
Cardiology$20.9M289$72.2K
Orthopedic Surgery$20.8M414$50.3K
Centralized Flu$20.4M230$88.9K
Hospitalist$18.5M553$33.4K
Rheumatology$16.4M97$168.6K
Pathology$16.1M265$60.8K
Hematology-Oncology$15.1M201$75.1K
Optometry$14.1M633$22.3K
Chiropractic$13.0M1.2K$10.5K
Nephrology$12.9M142$90.6K
Radiation Oncology$12.4M124$100.4K

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • CMS National Health Expenditure Data

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.