This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 69% 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 | $165.52 | $82.93 | 2.00x | $82.59 | $577.7K | 10.9K | 7.2K |
| 2015 | $149.05 | $74.36 | 2.00x | $74.69 | $454.8K | 9.4K | 6.3K |
| 2016 | $133.92 | $68.80 | 1.95x | $65.12 | $453.7K | 9.9K | 6.7K |
| 2017 | $128.32 | $60.35 | 2.13x | $67.97 | $254.2K | 6.5K | 4.6K |
| 2018 | $127.21 | $57.44 | 2.21x | $69.77 | $249.7K | 5.9K | 4.1K |
| 2019 | $114.87 | $54.06 | 2.12x | $60.81 | $233.4K | 5.2K | 3.5K |
| 2020 | $138.34 | $64.66 | 2.14x | $73.68 | $276.6K | 5.4K | 3.7K |
| 2021 | $146.41 | $72.25 | 2.03x | $74.16 | $340.3K | 6.2K | 3.7K |
| 2022 | $147.56 | $74.33 | 1.99x | $73.23 | $575.1K | 10.2K | 4.9K |
| 2023 | $159.14 | $81.66 | 1.95x | $77.48 | $750.3K | 11.5K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11100 | Biopsy of single growth of skin and/or tissue | 9.1K | $512.9K | $56.57 | 1.87x |
| 12032 | Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs | 2.6K | $503.8K | $196.17 | 1.64x |
| 11102 | Tangential biopsy of single skin lesion | 6.7K | $343.5K | $51.55 | 2.14x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.9K | $340.7K | $49.12 | 1.77x |
| 17110 | Destruction of up to 14 skin growths | 4.4K | $296.2K | $68.02 | 1.77x |
| 77280 | Obtaining data needed to develop the optimal radiation treatment, 1 treatment area | 1.4K | $251.7K | $175.56 | 1.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.7K | $246.0K | $66.19 | 1.71x |
| 17000 | Destruction of skin growth | 9.0K | $239.8K | $26.56 | 2.74x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 7.1K | $218.2K | $30.58 | 1.71x |
| 11103 | Tangential biopsy of additional skin lesion | 4.6K | $158.3K | $34.44 | 1.64x |
| 11101 | Biopsy of each additional growth of skin and/or tissue | 6.1K | $125.1K | $20.63 | 1.65x |
| 77401 | Superficial and/or low voltage radiation treatment delivery | 3.4K | $106.7K | $31.43 | 1.39x |
| 77285 | Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas | 338 | $96.7K | $285.97 | 1.60x |
| 11602 | Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs | 1.0K | $86.6K | $83.84 | 3.13x |
| 77290 | Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved | 262 | $77.6K | $296.14 | 1.64x |
| 11402 | Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs | 1.3K | $72.3K | $57.00 | 3.15x |
| 69100 | Biopsy of ear | 1.7K | $58.2K | $34.72 | 3.03x |
| 11301 | Shaving of 0.6 centimeters to 1.0 centimeters skin growth of the trunk, arms, or legs | 675 | $42.8K | $63.45 | 2.00x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 567 | $36.0K | $63.56 | 1.79x |
| 17004 | Destruction of 15 or more skin growths | 353 | $31.0K | $87.75 | 1.91x |
This provider submits charges 1.9 times higher than what Medicare actually pays.
A markup ratio of 1.9x means for every $100 Medicare pays, this provider initially charges $190. 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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