This provider's $9.2M in total Medicare payments ranks in the 99th percentile of Hospitalist providers nationally.
Medicare payments to this provider grew 226% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 158% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $493.90 | $70.28 | 7.03x | $423.62 | $440.4K | 4.2K | 2.9K |
| 2015 | $486.93 | $76.03 | 6.40x | $410.90 | $385.5K | 4.4K | 3.4K |
| 2016 | $471.94 | $81.27 | 5.81x | $390.67 | $398.4K | 5.0K | 4.0K |
| 2017 | $442.03 | $81.02 | 5.46x | $361.01 | $312.3K | 4.6K | 3.6K |
| 2018 | $355.07 | $78.98 | 4.50x | $276.09 | $804.4K | 9.3K | 2.3K |
| 2019 | $326.74 | $85.55 | 3.82x | $241.19 | $910.2K | 11.1K | 3.2K |
| 2020 | $245.22 | $71.44 | 3.43x | $173.78 | $1.3M | 17.0K | 4.1K |
| 2021 | $244.64 | $75.60 | 3.24x | $169.04 | $1.6M | 20.0K | 5.1K |
| 2022 | $230.33 | $71.20 | 3.23x | $159.13 | $1.6M | 21.3K | 5.2K |
| 2023 | $273.46 | $74.74 | 3.66x | $198.72 | $1.4M | 17.7K | 4.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 58.5K | $4.7M | $79.74 | 1.96x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 6.2K | $1.0M | $167.41 | 2.99x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 18.0K | $994.7K | $55.30 | 2.18x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 6.6K | $966.3K | $146.89 | 2.11x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.2K | $334.8K | $79.30 | 2.74x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.7K | $189.2K | $111.68 | 2.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $164.0K | $112.16 | 3.06x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 899 | $135.2K | $150.35 | 2.76x |
| 31624 | Irrigation and suction of lung airways to obtain cells using an endoscope | 1.3K | $74.1K | $56.43 | 8.75x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 576 | $59.4K | $103.19 | 4.31x |
| 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 742 | $59.0K | $79.53 | 4.25x |
| 31500 | Emergent insertion of breathing tube into windpipe cartilage using an endoscope | 591 | $59.0K | $99.85 | 2.71x |
| 31652 | Examination of lung airways using an endoscope with imaging guidance and ultrasound | 208 | $35.3K | $169.72 | 3.84x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 957 | $34.5K | $36.08 | 1.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 584 | $32.5K | $55.67 | 2.55x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 2.9K | $31.7K | $11.05 | 10.10x |
| 32555 | Removal of fluid from chest cavity with imaging guidance | 319 | $25.6K | $80.16 | 5.45x |
| 94729 | Measurement of lung diffusing capacity | 2.6K | $25.3K | $9.68 | 5.21x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 242 | $23.6K | $97.41 | 4.46x |
| 31629 | Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope | 145 | $21.7K | $149.88 | 7.84x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. 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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