This provider's $6.8M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) 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 | $195.53 | $70.82 | 2.76x | $124.71 | $791.9K | 8.9K | 2.7K |
| 2015 | $175.22 | $72.48 | 2.42x | $102.74 | $697.1K | 7.8K | 2.8K |
| 2016 | $179.60 | $69.20 | 2.60x | $110.40 | $611.5K | 6.8K | 2.7K |
| 2017 | $185.24 | $67.41 | 2.75x | $117.83 | $635.8K | 7.4K | 2.6K |
| 2018 | $172.56 | $73.19 | 2.36x | $99.37 | $716.7K | 7.6K | 2.7K |
| 2019 | $186.72 | $85.85 | 2.17x | $100.87 | $681.2K | 6.8K | 2.4K |
| 2020 | $279.08 | $87.02 | 3.21x | $192.06 | $793.0K | 7.1K | 2.1K |
| 2021 | $325.30 | $99.10 | 3.28x | $226.20 | $615.1K | 5.1K | 2.0K |
| 2022 | $301.79 | $90.40 | 3.34x | $211.39 | $616.5K | 5.4K | 2.1K |
| 2023 | $303.35 | $97.34 | 3.12x | $206.01 | $651.9K | 5.5K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 26.1K | $2.3M | $87.84 | 2.21x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 10.0K | $1.8M | $183.67 | 2.54x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 12.3K | $733.0K | $59.82 | 2.29x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.0K | $524.7K | $87.07 | 2.52x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.9K | $502.3K | $127.19 | 2.24x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.5K | $408.7K | $165.12 | 2.08x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 651 | $75.8K | $116.39 | 1.81x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 661 | $51.9K | $78.57 | 1.91x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 274 | $45.5K | $166.02 | 2.34x |
| 31645 | Aspiration of lung secretions from lung airways using an endoscope | 316 | $40.2K | $127.06 | 4.45x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 285 | $34.3K | $120.32 | 2.57x |
| 94729 | Measurement of lung diffusing capacity | 675 | $30.1K | $44.56 | 2.86x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 665 | $27.9K | $41.96 | 4.49x |
| 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 | 543 | $24.5K | $45.08 | 2.88x |
| 99239 | Hospital discharge day management, more than 30 minutes | 263 | $23.6K | $89.82 | 2.10x |
| 99292 | Critical care delivery critically ill or injured patient | 253 | $23.4K | $92.39 | 2.40x |
| 94727 | Determination of lung volumes using gas dilution or washout | 675 | $23.1K | $34.23 | 3.43x |
| 90670 | Pneumococcal vaccine for injection into muscle | 94 | $18.2K | $193.75 | 1.24x |
| 31500 | Emergent insertion of breathing tube into windpipe cartilage using an endoscope | 137 | $15.0K | $109.65 | 2.85x |
| 95800 | Study of sleep patterns | 187 | $11.6K | $62.11 | 3.22x |
This provider submits charges 2.37 times higher than what Medicare actually pays.
A markup ratio of 2.37x means for every $100 Medicare pays, this provider initially charges $237. 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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