This provider's $11.2M in total Medicare payments ranks in the 99th percentile of Plastic and Reconstructive Surgery providers nationally.
Medicare payments to this provider grew 14046% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 16122% in 2023
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 | $480.82 | $116.88 | 4.11x | $363.94 | $46.0K | 394 | 6 |
| 2015 | $380.17 | $98.20 | 3.87x | $281.97 | $70.6K | 719 | 11 |
| 2016 | $545.18 | $128.11 | 4.26x | $417.07 | $168.1K | 1.3K | 5 |
| 2017 | $572.65 | $121.58 | 4.71x | $451.07 | $482.1K | 4.0K | 9 |
| 2018 | $587.28 | $125.19 | 4.69x | $462.09 | $1.2M | 9.4K | 9 |
| 2019 | $574.64 | $122.39 | 4.70x | $452.25 | $916.1K | 7.5K | 8 |
| 2020 | $549.00 | $122.90 | 4.47x | $426.10 | $652.3K | 5.3K | 6 |
| 2021 | $544.35 | $118.33 | 4.60x | $426.02 | $1.1M | 9.2K | 4 |
| 2022 | $335.39 | $136.13 | 2.46x | $199.26 | $40.2K | 295 | 2 |
| 2023 | $535.57 | $377.68 | 1.42x | $157.89 | $6.5M | 17.2K | 7 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 5.4K | $4.3M | $788.96 | 1.28x |
| Q4186 | Epifix, per square centimeter | 18.8K | $2.4M | $125.45 | 4.78x |
| Q4227 | Amniocore, per square centimeter | 8.7K | $2.0M | $231.22 | 1.51x |
| Q4131 | Epifix or epicord, per square centimeter | 12.4K | $1.6M | $127.65 | 4.70x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 2.3K | $261.1K | $115.93 | 2.78x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 3.1K | $163.0K | $52.14 | 3.24x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 882 | $143.2K | $162.40 | 3.20x |
| 15734 | Muscle flap wound repair at trunk | 80 | $53.9K | $673.64 | 5.57x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 694 | $50.8K | $73.25 | 3.34x |
| 17250 | Application of chemical to stop tissue regrowth in wound | 1.3K | $44.9K | $33.98 | 5.59x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 305 | $43.2K | $141.49 | 3.37x |
| 14302 | Tissue transfer repair of wound (30.0 sq centimeters) | 231 | $37.9K | $163.96 | 3.66x |
| 15002 | Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children) | 129 | $27.2K | $210.98 | 4.59x |
| 19371 | Removal of capsule surrounding breast | 30 | $19.7K | $655.57 | 6.12x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 142 | $15.3K | $108.10 | 3.43x |
| 15003 | Preparation of graft site at trunk, arms, or legs | 382 | $13.4K | $35.00 | 5.14x |
| 14301 | Tissue transfer repair of wound (30.1 to 60.0 sq centimeters) | 26 | $12.7K | $489.13 | 5.72x |
| 15271 | Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) | 128 | $11.6K | $90.77 | 4.41x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 59 | $4.7K | $79.40 | 3.02x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 28 | $4.3K | $155.23 | 2.90x |
This provider submits charges 2.74 times higher than what Medicare actually pays.
A markup ratio of 2.74x means for every $100 Medicare pays, this provider initially charges $274. 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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