This provider's $6.4M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation providers nationally.
70% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
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 | $372.79 | $80.09 | 4.65x | $292.70 | $677.3K | 10.2K | 2.6K |
| 2015 | $356.43 | $78.36 | 4.55x | $278.07 | $711.2K | 10.7K | 2.8K |
| 2016 | $371.38 | $80.66 | 4.60x | $290.72 | $683.0K | 10.3K | 2.7K |
| 2017 | $345.95 | $77.46 | 4.47x | $268.49 | $657.9K | 10.2K | 2.8K |
| 2018 | $355.98 | $74.37 | 4.79x | $281.61 | $536.1K | 7.9K | 2.3K |
| 2019 | $355.45 | $74.76 | 4.75x | $280.69 | $537.6K | 8.0K | 2.3K |
| 2020 | $449.73 | $95.08 | 4.73x | $354.65 | $513.7K | 7.8K | 1.7K |
| 2021 | $391.24 | $84.40 | 4.64x | $306.84 | $683.2K | 9.9K | 2.1K |
| 2022 | $328.80 | $82.71 | 3.98x | $246.09 | $699.5K | 10.3K | 2.3K |
| 2023 | $264.26 | $82.29 | 3.21x | $181.97 | $731.2K | 10.5K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 78.2K | $4.5M | $57.51 | 4.14x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 7.6K | $1.2M | $155.75 | 4.08x |
| 99239 | Hospital discharge day management, more than 30 minutes | 6.5K | $550.5K | $84.91 | 4.44x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 986 | $72.3K | $73.36 | 6.01x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.5K | $51.1K | $35.10 | 4.36x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 354 | $38.0K | $107.44 | 4.44x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 461 | $19.5K | $42.37 | 4.25x |
| 99238 | Hospital discharge day management, 30 minutes or less | 205 | $11.7K | $56.95 | 4.62x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 76 | $4.1K | $53.55 | 4.35x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 28 | $2.8K | $100.57 | 2.88x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 34 | $2.8K | $81.08 | 4.93x |
This provider submits charges 4.18 times higher than what Medicare actually pays.
A markup ratio of 4.18x means for every $100 Medicare pays, this provider initially charges $418. 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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