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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Marc Hirsh
⚕️
MDIndividual

Marc Hirsh, M.D.

NPI: 1285735944
Delray Beach, FL
10 years of data
Rheumatology
$33.8M
Total Payments
515
Beneficiaries
2.7M
Services
3.23x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$33.8M
Specialty median$352.6K
Rank #31 of 32 in specialty

📋 Key Findings

1Billed $33.8M over 10 years
23.23x markup ratio (above median)
399th percentile in Rheumatology by payments
41.1K services/day — physically implausible
511 procedures with >3x markup

⚠️ This provider averages 1.1K services per working day — physically unusual for an individual practitioner

Based on 2.7M total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $33.8M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.

Averaging 1.1K services per working day raises questions about billing patterns.

Medicare payments to this provider grew 181% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$41.93$14.972.80x$26.96$1.6M108.3K43
2015$33.43$12.782.62x$20.65$2.1M164.4K46
2016$32.19$12.692.54x$19.50$2.7M210.2K48
2017$29.36$11.932.46x$17.43$2.5M211.8K48
2018$28.61$12.312.32x$16.30$2.7M216.9K48
2019$42.11$13.443.13x$28.67$3.5M261.0K55
2020$43.39$13.703.17x$29.69$4.5M328.5K58
2021$40.30$12.593.20x$27.71$4.9M386.1K54
2022$46.28$11.434.05x$34.85$4.8M421.5K58
2023$46.54$10.734.34x$35.81$4.6M425.0K57

Top Procedures (20)

J0717Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)⚠ 3.1x markup
$8.2M
1.5M services$5.35/svc3.08x markup
J0129Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)⚠ 3.5x markup
$4.1M
108.4K services$37.64/svc3.52x markup
99214Established patient office or other outpatient visit, 30-39 minutes
$3.8M
43.7K services$88.01/svc2.58x markup
J0897Injection, denosumab, 1 mg
$3.7M
247.0K services$15.06/svc2.58x markup
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle
$1.5M
24.5K services$62.84/svc2.85x markup
76942Ultrasonic guidance for needle placement⚠ 6.7x markup
$1.5M
28.9K services$50.37/svc6.69x markup
20611Aspiration and/or injection of fluid large joint using ultrasound guidance
$1.3M
16.6K services$79.03/svc2.85x markup
20550Injection into tendon or ligament⚠ 4.0x markup
$780.9K
21.8K services$35.84/svc3.99x markup
J1602Injection, golimumab, 1 mg, for intravenous use⚠ 3.7x markup
$770.3K
61.6K services$12.51/svc3.69x markup
J3357Ustekinumab, for subcutaneous injection, 1 mg
$704.8K
4.8K services$147.74/svc2.59x markup
J3111Injection, romosozumab-aqqg, 1 mg⚠ 3.1x markup
$542.1K
71.8K services$7.55/svc3.06x markup
76881Complete ultrasound scan of joint
$513.9K
6.8K services$75.12/svc2.89x markup
20606Aspiration and/or injection of fluid from medium joint using ultrasound guidance⚠ 3.3x markup
$472.4K
7.4K services$64.00/svc3.32x markup
99204New patient office or other outpatient visit, 45-59 minutes
$443.7K
3.5K services$127.62/svc2.90x markup
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg⚠ 7.1x markup
$350.0K
289.9K services$1.21/svc7.08x markup
J3262Injection, tocilizumab, 1 mg⚠ 3.1x markup
$345.0K
74.0K services$4.66/svc3.07x markup
99213Established patient office or other outpatient visit, 20-29 minutes
$333.4K
5.5K services$60.16/svc2.49x markup
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
$326.5K
30.9K services$10.57/svc2.02x markup
J7326Hyaluronan or derivative, gel-one, for intra-articular injection, per dose⚠ 3.4x markup
$311.4K
437 services$712.69/svc3.37x markup
64418Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve⚠ 3.0x markup
$286.1K
3.2K services$89.71/svc3.02x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J0717Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)1.5M$8.2M$5.353.08x
J0129Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)108.4K$4.1M$37.643.52x
99214Established patient office or other outpatient visit, 30-39 minutes43.7K$3.8M$88.012.58x
J0897Injection, denosumab, 1 mg247.0K$3.7M$15.062.58x
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle24.5K$1.5M$62.842.85x
76942Ultrasonic guidance for needle placement28.9K$1.5M$50.376.69x
20611Aspiration and/or injection of fluid large joint using ultrasound guidance16.6K$1.3M$79.032.85x
20550Injection into tendon or ligament21.8K$780.9K$35.843.99x
J1602Injection, golimumab, 1 mg, for intravenous use61.6K$770.3K$12.513.69x
J3357Ustekinumab, for subcutaneous injection, 1 mg4.8K$704.8K$147.742.59x
J3111Injection, romosozumab-aqqg, 1 mg71.8K$542.1K$7.553.06x
76881Complete ultrasound scan of joint6.8K$513.9K$75.122.89x
20606Aspiration and/or injection of fluid from medium joint using ultrasound guidance7.4K$472.4K$64.003.32x
99204New patient office or other outpatient visit, 45-59 minutes3.5K$443.7K$127.622.90x
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg289.9K$350.0K$1.217.08x
J3262Injection, tocilizumab, 1 mg74.0K$345.0K$4.663.07x
99213Established patient office or other outpatient visit, 20-29 minutes5.5K$333.4K$60.162.49x
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg30.9K$326.5K$10.572.02x
J7326Hyaluronan or derivative, gel-one, for intra-articular injection, per dose437$311.4K$712.693.37x
64418Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve3.2K$286.1K$89.713.02x

Markup Analysis

Charge-to-Payment Ratio

3.23x

This provider submits charges 3.23 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. This is higher than the national average.

Location

Delray Beach, FL

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Rheumatology providers in FL for peer comparison.

Marc Hirsh (you)
$33.8M
Aymen Kenawy, M.D.
$56.3M
Vipul Joshi, MD
$41.8M
Adam Rosen, MD
$38.6M
Eugenia Rullan Bidot, MD
$38.2M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Aymen Kenawy, M.D.Lynn Haven, FL$56.3M✓ Clear
Vipul Joshi, MDBrandon, FL$41.8M✓ Clear
Adam Rosen, MDClearwater, FL$38.6M✓ Clear
Eugenia Rullan Bidot, MDClearwater, FL$38.2M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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