This provider's $3.7M in total Medicare payments ranks in the 99th percentile of General Surgery providers nationally.
Medicare payments to this provider grew 128% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 62% 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 |
|---|---|---|---|---|---|---|---|
| 2018 | $287.28 | $84.96 | 3.38x | $202.32 | $338.6K | 3.6K | 1.0K |
| 2019 | $275.50 | $83.32 | 3.31x | $192.18 | $549.5K | 5.2K | 1.5K |
| 2020 | $297.47 | $88.59 | 3.36x | $208.88 | $572.3K | 5.3K | 1.8K |
| 2021 | $315.32 | $90.23 | 3.49x | $225.09 | $677.4K | 6.6K | 2.3K |
| 2022 | $293.44 | $79.00 | 3.71x | $214.44 | $794.4K | 8.5K | 2.4K |
| 2023 | $312.14 | $88.38 | 3.53x | $223.76 | $771.1K | 8.1K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 10.8K | $1.8M | $168.11 | 3.49x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 8.0K | $494.9K | $61.56 | 5.34x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 5.8K | $446.7K | $76.97 | 2.94x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 5.8K | $328.8K | $56.80 | 2.94x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 1.1K | $271.7K | $241.71 | 3.27x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 1.1K | $78.4K | $70.99 | 2.95x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 468 | $64.4K | $137.60 | 2.86x |
| 17250 | Application of chemical agent to excessive wound tissue | 1.5K | $51.2K | $33.20 | 6.98x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 320 | $35.6K | $111.38 | 2.97x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 853 | $29.6K | $34.65 | 2.92x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 357 | $29.1K | $81.60 | 2.99x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 184 | $19.5K | $106.06 | 2.92x |
| 11046 | Removal of skin and/or muscle | 301 | $16.5K | $54.77 | 3.45x |
| 11045 | Removal of skin and tissue | 266 | $7.7K | $28.95 | 3.61x |
| 99335 | Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes | 56 | $4.3K | $77.07 | 2.91x |
| 99334 | Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes | 59 | $2.9K | $48.93 | 2.89x |
| 99325 | New patient custodial care facility, group care, or assisted living visit, typically 30 minutes | 26 | $1.6K | $61.33 | 3.02x |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | 38 | $1.3K | $32.99 | 3.04x |
| 97598 | Removal of tissue from wound, each additional 20.0 sq cm | 31 | $1.1K | $35.17 | 3.10x |
| G0407 | Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth | 16 | $972.32 | $60.77 | 3.03x |
This provider submits charges 3.61 times higher than what Medicare actually pays.
A markup ratio of 3.61x means for every $100 Medicare pays, this provider initially charges $361. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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