This provider's $8.9M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $386.11 | $84.18 | 4.59x | $301.93 | $603.9K | 7.8K | 5.3K |
| 2015 | $494.14 | $91.04 | 5.43x | $403.10 | $811.3K | 9.6K | 6.3K |
| 2016 | $471.34 | $88.59 | 5.32x | $382.75 | $885.9K | 10.6K | 6.4K |
| 2017 | $476.06 | $82.71 | 5.76x | $393.35 | $1.0M | 12.3K | 7.3K |
| 2018 | $512.03 | $88.08 | 5.81x | $423.95 | $1.0M | 12.6K | 7.8K |
| 2019 | $557.81 | $101.01 | 5.52x | $456.80 | $1.1M | 11.8K | 7.6K |
| 2020 | $520.21 | $108.68 | 4.79x | $411.53 | $1.0M | 9.8K | 6.6K |
| 2021 | $495.61 | $110.52 | 4.48x | $385.09 | $925.8K | 8.8K | 6.1K |
| 2022 | $551.34 | $121.04 | 4.56x | $430.30 | $756.1K | 6.8K | 5.1K |
| 2023 | $553.17 | $120.14 | 4.60x | $433.03 | $822.9K | 7.5K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 15.1K | $1.3M | $86.49 | 3.27x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 6.1K | $1.2M | $202.53 | 4.79x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 3.2K | $1.0M | $325.87 | 4.37x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 3.3K | $677.8K | $204.27 | 3.31x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 6.1K | $639.6K | $105.59 | 5.17x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 3.1K | $632.4K | $203.22 | 3.82x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 4.6K | $485.7K | $104.84 | 5.46x |
| 95911 | Nerve transmission studies, 9-10 studies | 2.3K | $421.1K | $180.82 | 4.63x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 3.2K | $414.9K | $131.28 | 4.51x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.5K | $314.6K | $127.45 | 3.32x |
| 95886 | Needle measurement and recording of electrical activity of muscles of arm or leg complete study | 3.0K | $239.7K | $79.91 | 6.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.4K | $197.0K | $58.07 | 3.31x |
| 62311 | Injections of substances into lower or sacral spine | 1.1K | $168.3K | $150.28 | 3.65x |
| 64484 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 1.9K | $153.1K | $82.25 | 3.45x |
| 72148 | MRI scan of lower spinal canal | 1.2K | $142.9K | $117.04 | 14.47x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 1.0K | $135.8K | $132.77 | 8.89x |
| 72114 | X-ray lower and sacral spine including bending views minimum 6 views | 1.9K | $94.2K | $48.94 | 4.81x |
| 95912 | Nerve transmission studies, 11-12 studies | 299 | $63.7K | $212.93 | 4.22x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 406 | $50.3K | $123.84 | 3.23x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 205 | $34.7K | $169.05 | 3.29x |
This provider submits charges 4.5 times higher than what Medicare actually pays.
A markup ratio of 4.5x means for every $100 Medicare pays, this provider initially charges $450. 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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