This provider's $4.2M in total Medicare payments ranks in the 99th percentile of General Surgery providers nationally.
Medicare payments to this provider grew 285% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 129% 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 |
|---|---|---|---|---|---|---|---|
| 2016 | $312.50 | $58.56 | 5.34x | $253.94 | $195.7K | 3.8K | 944 |
| 2017 | $322.59 | $60.57 | 5.33x | $262.02 | $297.5K | 5.5K | 1.4K |
| 2018 | $314.25 | $55.20 | 5.69x | $259.05 | $192.2K | 4.6K | 1.4K |
| 2019 | $363.54 | $84.72 | 4.29x | $278.82 | $440.8K | 5.2K | 989 |
| 2020 | $563.27 | $142.38 | 3.96x | $420.89 | $757.3K | 6.8K | 1.0K |
| 2021 | $570.09 | $139.61 | 4.08x | $430.48 | $877.3K | 5.9K | 1.1K |
| 2022 | $598.66 | $124.93 | 4.79x | $473.73 | $674.2K | 6.0K | 1.1K |
| 2023 | $557.59 | $136.75 | 4.08x | $420.84 | $753.9K | 6.2K | 1.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11042 | Removal of skin and tissue first 20 sq cm or less | 16.6K | $1.3M | $78.89 | 3.99x |
| Q4159 | Affinity, per square centimeter | 800 | $539.5K | $674.43 | 4.89x |
| 99183 | Management and supervision of oxygen chamber therapy per session | 4.3K | $355.2K | $83.19 | 6.14x |
| G0277 | Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval | 3.0K | $339.4K | $113.98 | 4.53x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 1.2K | $261.9K | $215.55 | 4.28x |
| Q4194 | Novachor, per square centimeter | 237 | $191.4K | $807.52 | 3.96x |
| 15271 | Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) | 1.9K | $182.0K | $95.99 | 4.04x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $152.5K | $83.71 | 3.76x |
| 15275 | Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less) | 1.3K | $135.9K | $103.09 | 4.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 898 | $99.8K | $111.13 | 4.43x |
| Q4197 | Puraply xt, per square centimeter | 444 | $92.7K | $208.83 | 4.32x |
| 97597 | Removal of tissue from wounds per session | 2.6K | $81.2K | $31.19 | 4.29x |
| 11045 | Removal of skin and tissue | 2.9K | $79.1K | $27.55 | 4.29x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 577 | $76.4K | $132.38 | 4.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $57.5K | $44.13 | 4.64x |
| 97610 | Low frequency, non-contact, non-thermal ultrasound wound assessment, and instructions for ongoing care, per day | 196 | $48.6K | $248.01 | 2.78x |
| Q4186 | Epifix, per square centimeter | 270 | $33.8K | $125.23 | 5.19x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 522 | $27.5K | $52.66 | 5.20x |
| 29581 | Application of vein wound compression system lower leg below knee including ankle and foot | 668 | $25.9K | $38.75 | 6.43x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 365 | $23.7K | $64.85 | 4.73x |
This provider submits charges 4.43 times higher than what Medicare actually pays.
A markup ratio of 4.43x means for every $100 Medicare pays, this provider initially charges $443. 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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