Wisconsin Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
Wisconsin has 24K Medicare providers who collectively received $1252.7M in Medicare payments, averaging $51K per provider. With below-average per-provider Medicare revenue, Wisconsin practices may have substantial untapped potential in care management programs and E&M coding optimization.
The most common specialty is Nurse Practitioner with 3,640 providers, followed by Physician Assistant (2,359) and Family Practice (2,027). Nurse Practitioner providers in Wisconsin average $16K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Milwaukee (3,912 providers), with Madison and Green Bay also serving as major healthcare hubs. Practices in these areas face competitive pressure, making revenue optimization through proper coding and program enrollment critical for financial performance.
Total Providers
24K
in Wisconsin
Total Medicare Payment
$1252.7M
Avg Payment / Provider
$51K
Total Services
25.8M
Wisconsin Performance Signals
Revenue per Provider
$51,330
-35.6% vs benchmark · national avg $79,744
Provider Market Share
2.1% of US
+3.8% vs benchmark · 24,405 providers
CCM Adoption
0.4%
-96.5% vs benchmark · national 11.3%
RPM Adoption
0.1%
-98.8% vs benchmark · national 6.5%
AWV Completion
9.7%
-44.6% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How Wisconsin Compares
vs Neighboring States
Top Revenue Opportunities in Wisconsin
Chronic Care Management (99490)
Only 0.4% of providers bill CCM vs 11.3% national average. 2,653 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.1% vs 6.5% nationally. 1,559 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 9.7% trails the 17.5% national average. 1,900 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in Wisconsin
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 3,640 | $16K |
| Physician Assistant | 2,359 | $13K |
| Family Practice | 2,027 | $32K |
| Physical Therapist in Private Practice | 1,403 | $21K |
| Internal Medicine | 1,248 | $50K |
| Chiropractic | 1,238 | $11K |
| Emergency Medicine | 893 | $28K |
| Anesthesiology | 737 | $10K |
| Diagnostic Radiology | 732 | $66K |
| Optometry | 633 | $22K |
| Certified Registered Nurse Anesthetist (CRNA) | 615 | $6K |
| Hospitalist | 553 | $33K |
| Mass Immunizer Roster Biller | 506 | $44K |
| General Surgery | 432 | $19K |
| Orthopedic Surgery | 414 | $50K |
| Psychiatry | 345 | $18K |
| Ambulance Service Provider | 323 | $194K |
| Licensed Clinical Social Worker | 318 | $11K |
| Ophthalmology | 303 | $268K |
| Cardiology | 289 | $72K |
Top Cities in Wisconsin
Milwaukee
Madison
Green Bay
La Crosse
Eau Claire
Appleton
Waukesha
Wausau
Marshfield
Kenosha
Sheboygan
Janesville
Wauwatosa
Oshkosh
Fond Du Lac
Menomonee Falls
West Allis
Brookfield
Neenah
Mequon
West Bend
Greenfield
Mount Pleasant
Stevens Point
Grafton
Manitowoc
Franklin
Racine
Beloit
Burlington
Top 50 Providers in Wisconsin
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