This provider's $5.1M in total Medicare payments ranks in the 98th percentile of Interventional Pain Management providers nationally.
Their average markup ratio of 6.49x is significantly above the specialty median of 5.0x.
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 | $391.54 | $72.67 | 5.39x | $318.87 | $613.2K | 16.8K | 9.2K |
| 2015 | $429.76 | $76.25 | 5.64x | $353.51 | $620.0K | 17.2K | 9.4K |
| 2016 | $733.84 | $105.94 | 6.93x | $627.90 | $392.1K | 5.2K | 2.6K |
| 2017 | $754.55 | $105.02 | 7.18x | $649.53 | $499.7K | 6.5K | 2.7K |
| 2018 | $598.02 | $84.58 | 7.07x | $513.44 | $586.9K | 7.7K | 3.3K |
| 2019 | $522.47 | $103.46 | 5.05x | $419.01 | $543.0K | 7.4K | 3.2K |
| 2020 | $381.08 | $93.83 | 4.06x | $287.25 | $501.5K | 6.9K | 3.1K |
| 2021 | $366.35 | $98.13 | 3.73x | $268.22 | $483.1K | 6.2K | 2.8K |
| 2022 | $356.99 | $97.56 | 3.66x | $259.43 | $438.5K | 5.4K | 2.5K |
| 2023 | $359.61 | $94.97 | 3.79x | $264.64 | $374.4K | 4.5K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0482 | Drug test def 15-21 classes | 5.1K | $981.6K | $191.27 | 13.01x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.0K | $633.2K | $52.84 | 2.92x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.5K | $583.3K | $77.59 | 2.85x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 2.1K | $477.7K | $223.34 | 6.45x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 988 | $437.8K | $443.13 | 2.96x |
| 80307 | Testing for presence of drug | 4.5K | $282.2K | $62.83 | 10.18x |
| 64484 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 2.1K | $199.3K | $94.66 | 8.28x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 987 | $193.7K | $196.24 | 4.32x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 1.5K | $108.7K | $73.98 | 3.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 770 | $85.4K | $110.97 | 2.84x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 447 | $82.8K | $185.17 | 3.99x |
| 99152 | Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes | 2.1K | $79.8K | $37.41 | 11.85x |
| 62321 | Injection of substance into spinal canal of upper or middle back using imaging guidance | 277 | $50.1K | $180.81 | 4.60x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 446 | $43.1K | $96.62 | 4.03x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 639 | $38.0K | $59.39 | 16.55x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 351 | $33.5K | $95.53 | 4.00x |
| 82542 | Chemical analysis using chromatography technique | 1.4K | $33.0K | $24.06 | 3.12x |
| 83789 | Mass spectrometry (laboratory testing method) | 1.4K | $33.0K | $24.06 | 3.12x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 209 | $31.1K | $148.98 | 6.28x |
| 83992 | PCP drug level | 1.4K | $26.9K | $19.50 | 3.08x |
This provider submits charges 6.49 times higher than what Medicare actually pays.
A markup ratio of 6.49x means for every $100 Medicare pays, this provider initially charges $649. 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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