This provider's $7.4M in total Medicare payments ranks in the 99th percentile of Interventional Pain Management providers nationally.
Their average markup ratio of 5.33x is significantly above the specialty median of 5.0x.
Medicare payments to this provider grew 223% 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 | $585.21 | $71.23 | 8.22x | $513.98 | $364.8K | 4.6K | 1.8K |
| 2015 | $581.04 | $70.25 | 8.27x | $510.79 | $437.7K | 5.2K | 1.7K |
| 2016 | $648.19 | $72.59 | 8.93x | $575.60 | $483.7K | 6.6K | 2.2K |
| 2017 | $680.34 | $80.35 | 8.47x | $599.99 | $576.7K | 8.2K | 2.3K |
| 2018 | $742.23 | $80.37 | 9.24x | $661.86 | $694.6K | 9.7K | 2.6K |
| 2019 | $687.70 | $93.67 | 7.34x | $594.03 | $808.4K | 10.8K | 2.7K |
| 2020 | $676.14 | $92.13 | 7.34x | $584.01 | $832.2K | 10.8K | 2.3K |
| 2021 | $629.77 | $97.10 | 6.49x | $532.67 | $987.6K | 12.2K | 2.5K |
| 2022 | $561.36 | $102.84 | 5.46x | $458.52 | $1.0M | 12.8K | 2.5K |
| 2023 | $463.50 | $95.44 | 4.86x | $368.06 | $1.2M | 13.1K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 44.8K | $3.4M | $75.24 | 5.21x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 12.3K | $1.4M | $114.53 | 3.51x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 9.5K | $785.4K | $82.53 | 4.85x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 3.5K | $357.6K | $102.53 | 5.54x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.4K | $221.8K | $156.01 | 5.13x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 2.0K | $217.0K | $107.57 | 4.15x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 823 | $137.0K | $166.51 | 8.31x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 751 | $117.5K | $156.45 | 3.86x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.3K | $99.7K | $75.96 | 3.97x |
| 80305 | Testing for presence of drug | 7.0K | $90.5K | $12.99 | 15.70x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 822 | $74.2K | $90.31 | 12.28x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 801 | $73.4K | $91.64 | 12.66x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 510 | $51.7K | $101.32 | 3.87x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 577 | $50.7K | $87.89 | 13.35x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 233 | $45.6K | $195.58 | 8.71x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 542 | $29.4K | $54.17 | 3.89x |
| 64491 | Injections of upper or middle spine facet joint using imaging guidance | 235 | $24.1K | $102.64 | 8.17x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 112 | $21.6K | $192.43 | 4.16x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 637 | $19.8K | $31.07 | 6.44x |
| 62321 | Injection of substance into spinal canal of upper or middle back using imaging guidance | 160 | $19.3K | $120.44 | 6.89x |
This provider submits charges 5.33 times higher than what Medicare actually pays.
A markup ratio of 5.33x means for every $100 Medicare pays, this provider initially charges $533. 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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