This provider's $3.8M 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 | $242.51 | $78.55 | 3.09x | $163.96 | $379.4K | 8.0K | 3.3K |
| 2015 | $237.41 | $80.76 | 2.94x | $156.65 | $370.0K | 8.0K | 3.3K |
| 2016 | $228.71 | $77.72 | 2.94x | $150.99 | $364.2K | 7.9K | 3.2K |
| 2017 | $232.85 | $77.92 | 2.99x | $154.93 | $361.4K | 8.2K | 3.1K |
| 2018 | $232.85 | $76.69 | 3.04x | $156.16 | $377.7K | 9.0K | 3.2K |
| 2019 | $261.44 | $85.45 | 3.06x | $175.99 | $354.0K | 8.1K | 3.0K |
| 2020 | $260.36 | $90.51 | 2.88x | $169.85 | $337.2K | 6.8K | 3.0K |
| 2021 | $253.33 | $88.94 | 2.85x | $164.39 | $355.9K | 6.7K | 3.2K |
| 2022 | $249.41 | $87.38 | 2.85x | $162.03 | $424.6K | 8.0K | 3.4K |
| 2023 | $260.80 | $94.19 | 2.77x | $166.61 | $460.0K | 7.9K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 42.6K | $1.3M | $29.99 | 3.73x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 18.1K | $986.1K | $54.57 | 2.29x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 4.1K | $411.0K | $100.54 | 1.94x |
| 95911 | Nerve transmission studies, 9-10 studies | 1.9K | $300.8K | $156.35 | 2.89x |
| 99238 | Hospital discharge day management, 30 minutes or less | 4.4K | $237.9K | $54.39 | 2.21x |
| 95886 | Needle measurement and recording of electrical activity of muscles of arm or leg complete study | 2.9K | $205.2K | $70.33 | 2.66x |
| 95910 | Nerve transmission studies, 7-8 studies | 569 | $73.7K | $129.61 | 2.88x |
| 95909 | Nerve transmission studies, 5-6 studies | 741 | $72.1K | $97.33 | 2.91x |
| 95912 | Nerve transmission studies, 11-12 studies | 294 | $52.7K | $179.36 | 3.47x |
| 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 | 1.0K | $40.0K | $38.66 | 2.27x |
| 95885 | Needle measurement and recording of electrical activity of muscles of arm or leg limited study | 799 | $34.9K | $43.70 | 3.11x |
| 95913 | Nerve transmission studies, 13 or more studies | 140 | $29.5K | $210.57 | 2.93x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 131 | $19.3K | $147.23 | 2.04x |
| 99239 | Hospital discharge day management, more than 30 minutes | 186 | $14.8K | $79.36 | 1.95x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 197 | $14.7K | $74.44 | 2.28x |
| 74230 | Imaging for evaluation of swallowing function | 348 | $7.0K | $20.13 | 12.81x |
| G0179 | Physician re-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 im | 145 | $4.2K | $28.71 | 3.28x |
| 95908 | Nerve transmission studies, 3-4 studies | 18 | $1.6K | $86.47 | 2.68x |
This provider submits charges 2.87 times higher than what Medicare actually pays.
A markup ratio of 2.87x means for every $100 Medicare pays, this provider initially charges $287. 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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