This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
Medicare payments to this provider grew 10945% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 792% in 2018
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 | $138.75 | $68.71 | 2.02x | $70.04 | $7.4K | 117 | 83 |
| 2017 | $158.24 | $82.15 | 1.93x | $76.09 | $59.9K | 733 | 414 |
| 2018 | $240.37 | $112.66 | 2.13x | $127.71 | $533.8K | 4.8K | 1.1K |
| 2019 | $233.75 | $107.39 | 2.18x | $126.36 | $846.7K | 7.2K | 1.4K |
| 2020 | $238.22 | $108.73 | 2.19x | $129.49 | $854.2K | 7.4K | 1.4K |
| 2021 | $268.94 | $112.53 | 2.39x | $156.41 | $891.8K | 7.7K | 1.5K |
| 2022 | $313.60 | $127.99 | 2.45x | $185.61 | $956.9K | 6.9K | 1.3K |
| 2023 | $312.35 | $116.88 | 2.67x | $195.47 | $820.8K | 4.8K | 904 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 14.8K | $2.5M | $172.13 | 2.09x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 12.3K | $1.0M | $84.42 | 2.34x |
| 97610 | Therapy procedure using ultrasound | 1.6K | $589.0K | $358.05 | 2.18x |
| 49450 | Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin | 511 | $260.6K | $509.89 | 1.96x |
| 11046 | Removal of skin and/or muscle | 4.0K | $215.3K | $54.38 | 2.75x |
| 99348 | Established patient home visit, typically 25 minutes | 1.5K | $91.7K | $59.62 | 2.47x |
| 11045 | Removal of skin and tissue | 1.6K | $48.3K | $30.89 | 4.03x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 875 | $42.1K | $48.07 | 2.08x |
| 99343 | New patient home visit, typically 45 minutes | 353 | $31.3K | $88.73 | 2.59x |
| 99347 | Established patient home visit, typically 15 minutes | 581 | $23.3K | $40.02 | 2.50x |
| 93922 | Ultrasound study of arteries of both arms and legs | 276 | $18.9K | $68.43 | 2.19x |
| 17250 | Application of chemical agent to excessive wound tissue | 467 | $18.6K | $39.79 | 3.92x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 170 | $15.6K | $91.66 | 2.47x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 117 | $10.4K | $88.79 | 1.97x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 144 | $8.6K | $59.75 | 2.09x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 72 | $4.4K | $61.15 | 2.53x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 105 | $3.2K | $30.83 | 4.93x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 25 | $3.2K | $128.90 | 1.86x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 34 | $3.2K | $94.03 | 1.86x |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 47 | $2.4K | $52.05 | 4.64x |
This provider submits charges 2.22 times higher than what Medicare actually pays.
A markup ratio of 2.22x means for every $100 Medicare pays, this provider initially charges $222. 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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