This provider's $4.0M in total Medicare payments ranks in the 96th percentile of Independent Diagnostic Testing Facility (IDTF) providers nationally.
62% of their billing comes from a single procedure code (95811 — Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube).
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $1.3K | $237.32 | 5.52x | $1.1K | $360.3K | 1.0K | 978 |
| 2015 | $1.6K | $283.76 | 5.66x | $1.3K | $431.1K | 1.2K | 1.1K |
| 2016 | $1.8K | $316.37 | 5.58x | $1.4K | $564.1K | 1.4K | 1.3K |
| 2017 | $1.8K | $321.55 | 5.51x | $1.5K | $530.0K | 1.3K | 1.2K |
| 2018 | $1.8K | $336.66 | 5.41x | $1.5K | $527.7K | 1.2K | 1.1K |
| 2019 | $1.8K | $324.17 | 5.65x | $1.5K | $454.8K | 1.1K | 997 |
| 2020 | $1.8K | $312.18 | 5.81x | $1.5K | $316.3K | 800 | 735 |
| 2021 | $844.89 | $312.14 | 2.71x | $532.75 | $274.3K | 675 | 636 |
| 2022 | $502.46 | $305.62 | 1.64x | $196.84 | $242.3K | 646 | 621 |
| 2023 | $499.71 | $308.13 | 1.62x | $191.58 | $265.7K | 713 | 688 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 5.9K | $2.5M | $421.30 | 4.59x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 3.6K | $1.4M | $407.56 | 4.62x |
| 95806 | Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort | 512 | $42.4K | $82.88 | 6.15x |
| 94762 | Overnight measurement of oxygen saturation in blood using ear or finger device | 13 | $200.64 | $15.43 | 6.48x |
This provider submits charges 4.62 times higher than what Medicare actually pays.
A markup ratio of 4.62x means for every $100 Medicare pays, this provider initially charges $462. This is higher than the national average.
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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.
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