This provider's $3.6M in total Medicare payments ranks in the 98th percentile of Physical Medicine and Rehabilitation providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $232.08 | $76.76 | 3.02x | $155.32 | $484.1K | 8.4K | 2.8K |
| 2015 | $243.00 | $78.90 | 3.08x | $164.10 | $393.5K | 6.8K | 2.6K |
| 2016 | $232.91 | $77.80 | 2.99x | $155.11 | $376.3K | 6.3K | 2.6K |
| 2017 | $258.69 | $79.90 | 3.24x | $178.79 | $369.4K | 6.6K | 2.6K |
| 2018 | $258.72 | $81.09 | 3.19x | $177.63 | $379.6K | 6.1K | 2.3K |
| 2019 | $244.30 | $78.90 | 3.10x | $165.40 | $368.8K | 5.8K | 2.1K |
| 2020 | $242.21 | $79.34 | 3.05x | $162.87 | $305.8K | 4.4K | 2.0K |
| 2021 | $252.32 | $80.85 | 3.12x | $171.47 | $274.3K | 4.0K | 2.0K |
| 2022 | $246.03 | $76.17 | 3.23x | $169.86 | $342.1K | 5.4K | 1.9K |
| 2023 | $281.28 | $82.18 | 3.42x | $199.10 | $315.6K | 5.0K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 33.7K | $1.9M | $55.38 | 2.35x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.1K | $471.7K | $150.55 | 2.46x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.7K | $346.1K | $126.46 | 1.95x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 8.0K | $239.0K | $29.77 | 3.29x |
| 64644 | Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles | 1.5K | $179.2K | $119.29 | 3.77x |
| 95874 | Needle measurement and recording of electrical activity of muscles for guidance with injection of chemical for destruction of muscles | 2.9K | $164.5K | $56.52 | 2.02x |
| 64642 | Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles | 1.5K | $151.4K | $101.84 | 4.42x |
| 64643 | Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles | 1.8K | $124.9K | $69.13 | 6.51x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 381 | $39.4K | $103.40 | 2.69x |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 2.9K | $13.7K | $4.68 | 1.87x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 131 | $6.7K | $51.51 | 1.92x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 90 | $4.7K | $52.54 | 2.13x |
| 99203 | New patient outpatient visit, total time 30-44 minutes | 11 | $884.12 | $80.37 | 2.18x |
This provider submits charges 2.67 times higher than what Medicare actually pays.
A markup ratio of 2.67x means for every $100 Medicare pays, this provider initially charges $267. 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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