This provider's $5.7M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 88% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $253.33 | $82.19 | 3.08x | $171.14 | $557.6K | 8.6K | 2.4K |
| 2015 | $244.65 | $76.64 | 3.19x | $168.01 | $448.9K | 6.2K | 1.9K |
| 2016 | $310.36 | $88.13 | 3.52x | $222.23 | $424.0K | 6.0K | 1.6K |
| 2017 | $313.31 | $98.56 | 3.18x | $214.75 | $454.8K | 6.1K | 1.4K |
| 2018 | $297.87 | $97.38 | 3.06x | $200.49 | $320.2K | 3.8K | 1.4K |
| 2019 | $309.78 | $106.52 | 2.91x | $203.26 | $314.1K | 3.3K | 1.4K |
| 2020 | $310.38 | $102.80 | 3.02x | $207.58 | $591.2K | 3.2K | 1.1K |
| 2021 | $356.50 | $134.08 | 2.66x | $222.42 | $805.0K | 3.2K | 1.0K |
| 2022 | $385.84 | $146.83 | 2.63x | $239.01 | $992.7K | 3.3K | 1.0K |
| 2023 | $414.87 | $143.23 | 2.90x | $271.64 | $771.9K | 3.1K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 97610 | Low frequency, non-contact, non-thermal ultrasound wound assessment, and instructions for ongoing care, per day | 6.8K | $2.7M | $392.95 | 1.83x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 7.4K | $759.7K | $102.14 | 3.67x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.7K | $558.6K | $64.00 | 3.17x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.2K | $372.6K | $89.07 | 3.33x |
| 29580 | Strapping, Unna boot | 6.7K | $274.4K | $40.83 | 3.75x |
| 97597 | Removal of tissue from wounds per session | 2.2K | $157.6K | $70.97 | 3.31x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.3K | $133.4K | $58.99 | 3.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 894 | $124.9K | $139.67 | 3.02x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 678 | $116.5K | $171.76 | 2.91x |
| 15002 | Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children) | 292 | $88.0K | $301.54 | 2.98x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.3K | $71.9K | $56.10 | 3.26x |
| 99203 | New patient outpatient visit, total time 30-44 minutes | 468 | $44.8K | $95.65 | 3.46x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 543 | $38.3K | $70.53 | 3.31x |
| 29581 | Application of vein wound compression system lower leg below knee including ankle and foot | 507 | $37.0K | $73.03 | 3.07x |
| 15271 | Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) | 278 | $34.8K | $125.07 | 3.20x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 222 | $24.2K | $109.18 | 3.00x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 681 | $21.8K | $31.95 | 3.91x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 153 | $20.9K | $136.34 | 3.02x |
| 93922 | Ultrasound study of arteries of both arms and legs | 220 | $17.2K | $78.19 | 3.78x |
| 29445 | Application of rigid total contact leg cast | 140 | $16.2K | $115.42 | 3.29x |
This provider submits charges 2.65 times higher than what Medicare actually pays.
A markup ratio of 2.65x means for every $100 Medicare pays, this provider initially charges $265. 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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