This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
99% of their billing comes from a single procedure code (Q4205 — Membrane graft or membrane wrap, per square centimeter).
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 |
|---|---|---|---|---|---|---|---|
| 2023 | $1.4K | $1.0K | 1.31x | $319.22 | $3.8M | 3.6K | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 3.3K | $3.7M | $1.1K | 1.28x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 133 | $14.3K | $107.85 | 3.80x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 71 | $6.9K | $97.24 | 4.10x |
| 99284 | Emergency department visit with moderate level of medical decision making | 66 | $5.1K | $77.74 | 8.71x |
| 99285 | Emergency department visit with high level of medical decision making | 15 | $1.7K | $116.25 | 8.71x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 28 | $1.5K | $54.88 | 1.28x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 25 | $956.00 | $38.24 | 3.74x |
| 99283 | Emergency department visit with low level of medical decision making | 21 | $902.50 | $42.98 | 10.59x |
This provider submits charges 1.31 times higher than what Medicare actually pays.
A markup ratio of 1.31x means for every $100 Medicare pays, this provider initially charges $131. This is lower 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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