This provider's $10.2M in total Medicare payments ranks in the 99th percentile of General Surgery providers nationally.
Medicare payments to this provider grew 3826% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 809% in 2023
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 | $112.76 | $51.65 | 2.18x | $61.11 | $131.1K | 2.5K | 9 |
| 2015 | $194.88 | $60.05 | 3.25x | $134.83 | $72.5K | 1.2K | 9 |
| 2016 | $175.25 | $61.46 | 2.85x | $113.79 | $98.7K | 1.6K | 13 |
| 2017 | $172.34 | $66.45 | 2.59x | $105.89 | $109.5K | 1.6K | 12 |
| 2018 | $234.04 | $70.10 | 3.34x | $163.94 | $86.6K | 1.2K | 10 |
| 2019 | $242.78 | $105.04 | 2.31x | $137.74 | $368.8K | 3.5K | 9 |
| 2020 | $209.25 | $125.05 | 1.67x | $84.20 | $1.5M | 11.8K | 7 |
| 2021 | $205.53 | $124.32 | 1.65x | $81.21 | $2.2M | 17.4K | 3 |
| 2022 | $215.97 | $122.26 | 1.77x | $93.71 | $566.3K | 4.6K | 5 |
| 2023 | $1.2K | $842.00 | 1.38x | $316.00 | $5.1M | 6.1K | 5 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 5.6K | $5.1M | $904.84 | 1.35x |
| Q4186 | Epifix, per square centimeter | 34.2K | $4.3M | $125.53 | 1.59x |
| 15274 | Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs | 3.6K | $134.3K | $37.02 | 3.25x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 1.1K | $129.3K | $119.70 | 3.65x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.7K | $96.4K | $56.58 | 2.25x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 804 | $87.2K | $108.50 | 3.47x |
| 15273 | Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs (first 100 sq cm or 1% body area of infants and children) | 499 | $76.5K | $153.37 | 3.86x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 866 | $73.9K | $85.35 | 2.74x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 465 | $50.0K | $107.50 | 1.99x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 606 | $44.6K | $73.61 | 3.61x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 798 | $41.9K | $52.54 | 1.91x |
| 99183 | Management and supervision of oxygen chamber therapy per session | 256 | $24.0K | $93.66 | 3.11x |
| 17250 | Application of chemical to stop tissue regrowth in wound | 403 | $17.7K | $43.87 | 5.18x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 343 | $13.8K | $40.32 | 2.51x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 79 | $9.5K | $120.29 | 3.06x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 51 | $7.7K | $151.49 | 2.62x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 92 | $6.5K | $70.69 | 1.89x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 89 | $5.7K | $64.18 | 8.87x |
| 20240 | Biopsy of bone, open procedure | 48 | $3.1K | $63.90 | 6.43x |
This provider submits charges 1.6 times higher than what Medicare actually pays.
A markup ratio of 1.6x means for every $100 Medicare pays, this provider initially charges $160. 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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