This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Hospitalist providers nationally.
Medicare payments to this provider grew 94% from 2014 to 2023.
63% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 86% in 2015
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 | $181.90 | $86.21 | 2.11x | $95.69 | $256.3K | 6.0K | 2.2K |
| 2015 | $457.00 | $77.72 | 5.88x | $379.28 | $476.3K | 7.9K | 1.9K |
| 2016 | $473.72 | $79.37 | 5.97x | $394.35 | $523.3K | 8.9K | 1.9K |
| 2017 | $539.70 | $88.77 | 6.08x | $450.93 | $535.9K | 9.1K | 1.8K |
| 2018 | $539.70 | $92.83 | 5.81x | $446.87 | $585.5K | 9.5K | 2.0K |
| 2019 | $392.62 | $95.44 | 4.11x | $297.18 | $652.4K | 9.5K | 2.1K |
| 2020 | $403.88 | $95.11 | 4.25x | $308.77 | $587.5K | 8.4K | 1.9K |
| 2021 | $394.25 | $87.04 | 4.53x | $307.21 | $588.2K | 8.2K | 2.1K |
| 2022 | $396.59 | $88.77 | 4.47x | $307.82 | $520.0K | 7.5K | 1.8K |
| 2023 | $371.66 | $79.87 | 4.65x | $291.79 | $497.0K | 7.7K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 57.7K | $3.3M | $57.02 | 5.09x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 11.6K | $965.2K | $83.21 | 4.52x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.9K | $291.6K | $156.17 | 4.91x |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.4K | $203.8K | $84.52 | 5.02x |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.6K | $149.4K | $57.26 | 4.38x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 4.4K | $133.4K | $30.48 | 2.32x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.1K | $110.5K | $104.61 | 4.30x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 536 | $41.8K | $77.92 | 4.78x |
| 99217 | Hospital observation care discharge | 211 | $11.9K | $56.20 | 4.69x |
| 99220 | Hospital observation care typically 70 minutes per day | 77 | $11.0K | $142.39 | 4.67x |
| 99219 | Hospital observation care typically 50 minutes | 64 | $6.7K | $105.16 | 4.96x |
| 99497 | Advance care planning, first 30 minutes | 89 | $5.2K | $58.62 | 4.93x |
| 99218 | Hospital observation care typically 30 minutes | 11 | $853.35 | $77.58 | 5.79x |
This provider submits charges 4.86 times higher than what Medicare actually pays.
A markup ratio of 4.86x means for every $100 Medicare pays, this provider initially charges $486. 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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