This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation providers nationally.
Medicare payments to this provider grew 208% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 215% in 2017
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 | $158.40 | $86.57 | 1.83x | $71.83 | $237.0K | 3.7K | 1.5K |
| 2015 | $159.10 | $81.06 | 1.96x | $78.04 | $274.0K | 3.5K | 1.5K |
| 2016 | $163.81 | $84.67 | 1.93x | $79.14 | $207.7K | 2.5K | 1.3K |
| 2017 | $190.88 | $99.89 | 1.91x | $90.99 | $654.7K | 7.7K | 3.3K |
| 2018 | $194.17 | $101.39 | 1.92x | $92.78 | $483.4K | 5.7K | 2.4K |
| 2019 | $179.60 | $97.56 | 1.84x | $82.04 | $480.2K | 5.6K | 2.4K |
| 2020 | $183.74 | $101.77 | 1.81x | $81.97 | $456.0K | 5.0K | 1.8K |
| 2021 | $182.11 | $101.28 | 1.80x | $80.83 | $380.0K | 4.2K | 1.4K |
| 2022 | $158.47 | $86.21 | 1.84x | $72.26 | $271.4K | 3.4K | 1.5K |
| 2023 | $198.39 | $95.02 | 2.09x | $103.37 | $729.7K | 8.2K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 23.5K | $2.0M | $83.32 | 1.92x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.9K | $765.3K | $154.89 | 1.72x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 10.6K | $605.5K | $57.10 | 1.94x |
| 99239 | Hospital discharge day management, more than 30 minutes | 3.8K | $325.1K | $84.96 | 1.93x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 2.6K | $280.9K | $107.14 | 1.87x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 482 | $66.8K | $138.58 | 1.99x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 2.2K | $66.0K | $30.46 | 1.99x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 486 | $51.8K | $106.66 | 2.02x |
| 99497 | Advance care planning by the physician or other qualified health care professional, first 30 minutes | 702 | $41.2K | $58.75 | 2.23x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 78 | $5.6K | $71.82 | 2.02x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 29 | $4.8K | $167.14 | 1.50x |
| G0180 | Physician or allowed practitioner 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 and | 13 | $543.43 | $41.80 | 2.75x |
| 97761 | Training in the use of artificial arm and/or leg, each 15 minutes | 14 | $469.70 | $33.55 | 2.47x |
This provider submits charges 1.89 times higher than what Medicare actually pays.
A markup ratio of 1.89x means for every $100 Medicare pays, this provider initially charges $189. This is lower 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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