This provider's $4.6M 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 | $138.68 | $76.15 | 1.82x | $62.53 | $500.9K | 13.4K | 3.6K |
| 2015 | $128.71 | $63.76 | 2.02x | $64.95 | $379.8K | 10.1K | 2.8K |
| 2016 | $134.88 | $69.92 | 1.93x | $64.96 | $378.1K | 9.4K | 2.8K |
| 2017 | $128.40 | $64.72 | 1.98x | $63.68 | $399.9K | 10.1K | 3.0K |
| 2018 | $128.39 | $65.75 | 1.95x | $62.64 | $429.7K | 10.3K | 2.9K |
| 2019 | $119.00 | $62.91 | 1.89x | $56.09 | $477.1K | 10.8K | 3.0K |
| 2020 | $92.66 | $49.74 | 1.86x | $42.92 | $496.2K | 10.5K | 3.0K |
| 2021 | $121.75 | $63.71 | 1.91x | $58.04 | $476.4K | 10.3K | 3.2K |
| 2022 | $109.98 | $56.73 | 1.94x | $53.25 | $519.9K | 11.1K | 3.5K |
| 2023 | $119.62 | $70.04 | 1.71x | $49.58 | $590.7K | 10.6K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 35.1K | $2.0M | $58.01 | 1.88x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 59.0K | $1.9M | $31.38 | 2.13x |
| 99238 | Hospital discharge day management, 30 minutes or less | 11.5K | $662.3K | $57.76 | 1.91x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 423 | $46.2K | $109.12 | 1.89x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 125 | $20.1K | $160.97 | 1.55x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 168 | $13.3K | $79.18 | 1.96x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 211 | $8.7K | $41.39 | 1.93x |
| 99239 | Hospital discharge day management, more than 30 minutes | 84 | $7.3K | $87.13 | 1.86x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 14 | $1.3K | $94.18 | 1.68x |
This provider submits charges 1.98 times higher than what Medicare actually pays.
A markup ratio of 1.98x means for every $100 Medicare pays, this provider initially charges $198. 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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