This provider's $4.5M in total Medicare payments ranks in the 98th percentile of Pain Management 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 126% in 2019
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 | $332.69 | $107.88 | 3.08x | $224.81 | $466.7K | 5.6K | 2.9K |
| 2015 | $301.02 | $86.69 | 3.47x | $214.33 | $481.1K | 5.8K | 3.0K |
| 2016 | $381.97 | $118.54 | 3.22x | $263.43 | $555.5K | 6.7K | 3.3K |
| 2017 | $333.09 | $96.95 | 3.44x | $236.14 | $407.3K | 4.9K | 2.6K |
| 2018 | $592.32 | $120.03 | 4.93x | $472.29 | $175.6K | 1.8K | 923 |
| 2019 | $610.37 | $109.82 | 5.56x | $500.55 | $396.6K | 4.3K | 2.0K |
| 2020 | $466.18 | $109.19 | 4.27x | $356.99 | $472.9K | 5.2K | 2.3K |
| 2021 | $475.63 | $112.91 | 4.21x | $362.72 | $493.5K | 5.2K | 2.3K |
| 2022 | $625.88 | $131.32 | 4.77x | $494.56 | $593.0K | 6.0K | 2.4K |
| 2023 | $679.69 | $111.95 | 6.07x | $567.74 | $476.6K | 5.2K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.4K | $1.0M | $88.62 | 4.65x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 3.5K | $675.5K | $194.67 | 4.34x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 1.1K | $374.5K | $332.58 | 3.71x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 1.7K | $354.8K | $208.73 | 4.32x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 3.4K | $347.4K | $101.50 | 4.17x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 1.6K | $292.6K | $177.56 | 5.10x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.0K | $248.2K | $122.52 | 4.07x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 2.1K | $205.3K | $98.93 | 4.23x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 945 | $192.5K | $203.73 | 4.08x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 1.1K | $165.5K | $149.33 | 3.85x |
| 64491 | Injections of upper or middle spine facet joint using imaging guidance | 912 | $94.4K | $103.49 | 4.32x |
| 64484 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 853 | $60.1K | $70.50 | 4.02x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.1K | $59.1K | $54.09 | 2.15x |
| 64492 | Injections of upper or middle spine facet joint using imaging guidance | 517 | $51.7K | $100.09 | 4.30x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.1K | $51.0K | $46.72 | 5.01x |
| 72148 | MRI scan of lower spinal canal | 213 | $34.9K | $164.06 | 5.03x |
| 20553 | Injections of trigger points in 3 or more muscles | 744 | $32.1K | $43.12 | 6.80x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 85 | $27.7K | $325.76 | 3.23x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 31 | $24.0K | $774.57 | 2.55x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 967 | $23.7K | $24.46 | 1.76x |
This provider submits charges 4.3 times higher than what Medicare actually pays.
A markup ratio of 4.3x means for every $100 Medicare pays, this provider initially charges $430. 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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