This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Plastic and Reconstructive Surgery providers nationally.
Medicare payments to this provider grew 232% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 65% in 2022
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $861.18 | $236.21 | 3.65x | $624.97 | $171.5K | 1.1K | 976 |
| 2015 | $857.65 | $193.16 | 4.44x | $664.49 | $208.0K | 1.6K | 1.5K |
| 2016 | $857.01 | $180.98 | 4.74x | $676.03 | $253.7K | 2.0K | 1.8K |
| 2017 | $776.90 | $186.23 | 4.17x | $590.67 | $285.9K | 2.3K | 2.1K |
| 2018 | $694.28 | $169.52 | 4.10x | $524.76 | $419.1K | 3.9K | 3.4K |
| 2019 | $664.16 | $166.95 | 3.98x | $497.21 | $405.2K | 4.1K | 3.5K |
| 2020 | $712.46 | $194.98 | 3.65x | $517.48 | $406.6K | 3.8K | 3.2K |
| 2021 | $452.48 | $136.28 | 3.32x | $316.20 | $337.8K | 3.3K | 2.8K |
| 2022 | $726.80 | $184.89 | 3.93x | $541.91 | $556.7K | 5.0K | 4.3K |
| 2023 | $797.45 | $198.23 | 4.02x | $599.22 | $568.7K | 5.2K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7308 | Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) | 1.5K | $444.6K | $290.56 | 2.08x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.8K | $398.6K | $83.86 | 3.27x |
| 14040 | Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 624 | $301.3K | $482.83 | 4.56x |
| 96574 | Application of light and light-sensitive drugs following removal of premalignant thickened skin growth, per day | 1.1K | $241.2K | $216.91 | 3.17x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.5K | $213.2K | $61.64 | 3.08x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 349 | $189.4K | $542.80 | 5.02x |
| 17000 | Destruction of skin growth | 4.0K | $185.2K | $46.66 | 3.60x |
| 14020 | Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs | 377 | $165.4K | $438.67 | 3.47x |
| 12032 | Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs | 624 | $155.8K | $249.73 | 2.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $141.0K | $119.29 | 3.64x |
| 11106 | Incisional biopsy of single skin lesion | 1.0K | $125.5K | $121.62 | 2.49x |
| 17110 | Destruction of up to 14 skin growths | 1.4K | $116.3K | $82.48 | 4.46x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 159 | $112.6K | $708.20 | 3.01x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $98.7K | $78.34 | 3.80x |
| 11100 | Biopsy of single growth of skin and/or tissue | 1.1K | $82.6K | $75.36 | 2.90x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 1.4K | $75.3K | $52.70 | 4.00x |
| 14041 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 87 | $53.8K | $617.97 | 6.05x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.5K | $52.7K | $34.39 | 4.11x |
| 11104 | Punch biopsy of single skin lesion | 483 | $48.0K | $99.40 | 2.35x |
| 96567 | Application of light to aid destruction of premalignant and/or malignant skin growths, each session | 416 | $48.0K | $115.27 | 2.88x |
This provider submits charges 3.48 times higher than what Medicare actually pays.
A markup ratio of 3.48x means for every $100 Medicare pays, this provider initially charges $348. 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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