This provider's $3.4M in total Medicare payments ranks in the 98th percentile of Pain Management providers nationally.
Their average markup ratio of 5.41x is significantly above the specialty median of 5.1x.
Medicare payments to this provider grew 328% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 159% in 2015
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 | $426.10 | $83.08 | 5.13x | $343.02 | $99.6K | 1.5K | 973 |
| 2015 | $450.43 | $88.66 | 5.08x | $361.77 | $258.1K | 4.4K | 2.6K |
| 2016 | $628.70 | $101.24 | 6.21x | $527.46 | $267.9K | 4.2K | 2.4K |
| 2017 | $838.46 | $113.71 | 7.37x | $724.75 | $342.9K | 5.6K | 3.2K |
| 2018 | $799.53 | $115.21 | 6.94x | $684.32 | $380.5K | 5.5K | 3.2K |
| 2019 | $817.46 | $126.53 | 6.46x | $690.93 | $401.7K | 5.9K | 3.1K |
| 2020 | $753.75 | $106.45 | 7.08x | $647.30 | $329.2K | 4.9K | 2.6K |
| 2021 | $691.74 | $106.19 | 6.51x | $585.55 | $368.2K | 5.6K | 2.9K |
| 2022 | $854.01 | $220.32 | 3.88x | $633.69 | $539.4K | 4.6K | 2.5K |
| 2023 | $812.40 | $220.45 | 3.69x | $591.95 | $426.3K | 3.8K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7999 | Compounded drug, not otherwise classified | 98 | $397.0K | $4.1K | 1.92x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 1.9K | $367.9K | $190.92 | 5.50x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 631 | $201.8K | $319.83 | 5.86x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 1.3K | $184.3K | $146.37 | 3.34x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 1.1K | $178.3K | $167.13 | 4.92x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 884 | $162.4K | $183.67 | 4.76x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 3.4K | $148.9K | $43.41 | 13.60x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 386 | $126.8K | $328.54 | 6.23x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $125.5K | $120.43 | 2.99x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.1K | $113.2K | $53.21 | 2.64x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 1.4K | $100.5K | $71.77 | 4.75x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 1.0K | $91.2K | $89.27 | 5.68x |
| 62321 | Injection of substance into spinal canal of upper or middle back using imaging guidance | 473 | $87.0K | $183.89 | 8.58x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 540 | $79.9K | $148.05 | 2.90x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 575 | $79.2K | $137.71 | 5.34x |
| 64491 | Injections of upper or middle spine facet joint using imaging guidance | 816 | $77.2K | $94.64 | 7.08x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 917 | $71.9K | $78.37 | 2.68x |
| 64484 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 994 | $66.5K | $66.92 | 7.68x |
| 64405 | Injection of anesthetic agent, greater occipital nerve | 775 | $64.5K | $83.29 | 5.52x |
| 64450 | Injection of anesthetic agent, other peripheral nerve or branch | 1.3K | $64.2K | $49.31 | 9.37x |
This provider submits charges 5.41 times higher than what Medicare actually pays.
A markup ratio of 5.41x means for every $100 Medicare pays, this provider initially charges $541. 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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