This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) providers nationally.
Medicare payments to this provider grew 145% from 2014 to 2023.
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 | $417.18 | $70.87 | 5.89x | $346.31 | $167.6K | 2.0K | 1.4K |
| 2015 | $368.21 | $65.39 | 5.63x | $302.82 | $244.1K | 3.2K | 2.3K |
| 2016 | $396.78 | $68.37 | 5.80x | $328.41 | $271.3K | 3.6K | 2.8K |
| 2017 | $368.12 | $65.17 | 5.65x | $302.95 | $283.6K | 3.7K | 2.5K |
| 2018 | $405.03 | $67.17 | 6.03x | $337.86 | $313.1K | 3.8K | 2.6K |
| 2019 | $312.70 | $72.76 | 4.30x | $239.94 | $367.3K | 4.4K | 3.1K |
| 2020 | $240.58 | $69.79 | 3.45x | $170.79 | $423.8K | 4.9K | 2.7K |
| 2021 | $281.47 | $82.73 | 3.40x | $198.74 | $401.6K | 4.8K | 2.5K |
| 2022 | $251.47 | $71.35 | 3.52x | $180.12 | $421.0K | 5.3K | 2.8K |
| 2023 | $241.25 | $71.16 | 3.39x | $170.09 | $411.2K | 4.8K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 7.8K | $635.9K | $81.25 | 3.88x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.2K | $591.7K | $82.61 | 2.86x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 2.9K | $484.2K | $168.35 | 7.30x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.6K | $236.7K | $150.58 | 4.48x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.9K | $204.9K | $109.86 | 3.13x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.4K | $204.7K | $148.87 | 3.09x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.4K | $189.0K | $55.85 | 3.84x |
| 95800 | Study of sleep patterns | 1.2K | $145.9K | $119.42 | 3.02x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 964 | $91.6K | $95.07 | 3.62x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $69.6K | $53.22 | 3.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 525 | $60.8K | $115.88 | 3.37x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 539 | $49.1K | $91.10 | 3.47x |
| 94729 | Measurement of lung diffusing capacity | 1.6K | $41.9K | $26.46 | 2.83x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 1.5K | $41.8K | $27.48 | 3.55x |
| 94727 | Determination of lung volumes using gas dilution or washout | 1.5K | $34.2K | $22.15 | 4.25x |
| 31653 | Examination of lung airways using an endoscope with imaging guidance and ultrasound | 241 | $33.8K | $140.22 | 3.90x |
| 94618 | Test for exercise-induced lung stress | 1.2K | $27.8K | $23.97 | 4.38x |
| 31629 | Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope | 136 | $14.9K | $109.26 | 4.86x |
| 31641 | Destruction of growth or narrowing of lung airway using an endoscope | 72 | $14.1K | $196.21 | 2.69x |
| 94620 | Pulmonary exercise testing | 493 | $13.4K | $27.13 | 4.06x |
This provider submits charges 4.19 times higher than what Medicare actually pays.
A markup ratio of 4.19x means for every $100 Medicare pays, this provider initially charges $419. 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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