This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Pain Management providers nationally.
Their average markup ratio of 5.75x is significantly above the specialty median of 5.1x.
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 | $347.20 | $90.22 | 3.85x | $256.98 | $510.0K | 6.4K | 2.9K |
| 2015 | $303.40 | $82.36 | 3.68x | $221.04 | $445.3K | 7.4K | 2.9K |
| 2016 | $591.14 | $110.50 | 5.35x | $480.64 | $522.3K | 5.4K | 2.2K |
| 2017 | $832.39 | $122.13 | 6.82x | $710.26 | $575.6K | 5.6K | 2.2K |
| 2018 | $880.03 | $128.80 | 6.83x | $751.23 | $541.6K | 5.0K | 2.5K |
| 2019 | $956.66 | $143.76 | 6.65x | $812.90 | $592.4K | 5.3K | 2.5K |
| 2020 | $946.05 | $150.37 | 6.29x | $795.68 | $619.4K | 5.4K | 2.4K |
| 2021 | $1.1K | $149.81 | 7.02x | $901.85 | $640.9K | 5.5K | 2.4K |
| 2022 | $999.02 | $163.54 | 6.11x | $835.48 | $647.8K | 5.5K | 2.4K |
| 2023 | $1.2K | $184.17 | 6.78x | $1.1K | $749.6K | 5.4K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.3K | $1.2M | $89.92 | 7.09x |
| J7999 | Compounded drug, not otherwise classified | 1.4K | $652.2K | $452.29 | 1.65x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.2K | $503.4K | $61.14 | 7.24x |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 2.0K | $468.4K | $238.40 | 6.31x |
| J3490 | Unclassified drugs | 1.2K | $365.0K | $315.72 | 1.71x |
| 62370 | Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician | 2.6K | $253.5K | $95.93 | 7.00x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 620 | $237.5K | $383.08 | 6.51x |
| 80307 | Testing for presence of drug | 3.6K | $231.1K | $63.77 | 6.67x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 799 | $172.7K | $216.15 | 6.13x |
| G0482 | Drug test def 15-21 classes | 752 | $137.1K | $182.34 | 5.41x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 353 | $130.5K | $369.73 | 6.98x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 621 | $123.5K | $198.91 | 5.38x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 560 | $118.8K | $212.18 | 7.96x |
| G0480 | Drug test def 1-7 classes | 949 | $104.4K | $109.96 | 5.96x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 769 | $99.5K | $129.34 | 6.83x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 579 | $99.4K | $171.59 | 5.98x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 393 | $83.4K | $212.27 | 5.57x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.4K | $72.4K | $50.29 | 8.04x |
| 62321 | Injection of substance into spinal canal of upper or middle back using imaging guidance | 322 | $70.5K | $219.07 | 7.97x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 574 | $60.2K | $104.84 | 5.02x |
This provider submits charges 5.75 times higher than what Medicare actually pays.
A markup ratio of 5.75x means for every $100 Medicare pays, this provider initially charges $575. 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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