This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 248% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 131% 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 | $183.09 | $48.48 | 3.78x | $134.61 | $253.8K | 4.7K | 948 |
| 2015 | $183.09 | $45.99 | 3.98x | $137.10 | $286.7K | 5.6K | 1.1K |
| 2016 | $167.63 | $41.86 | 4.00x | $125.77 | $179.1K | 3.8K | 1.0K |
| 2017 | $206.92 | $59.58 | 3.47x | $147.34 | $231.7K | 3.9K | 1.3K |
| 2018 | $246.63 | $69.88 | 3.53x | $176.75 | $535.2K | 7.9K | 2.6K |
| 2019 | $249.73 | $71.80 | 3.48x | $177.93 | $631.5K | 9.0K | 2.6K |
| 2020 | $264.16 | $74.29 | 3.56x | $189.87 | $837.5K | 11.4K | 3.3K |
| 2021 | $274.59 | $73.37 | 3.74x | $201.22 | $1.1M | 13.3K | 3.8K |
| 2022 | $299.13 | $78.40 | 3.82x | $220.73 | $865.1K | 11.2K | 3.7K |
| 2023 | $274.77 | $75.58 | 3.64x | $199.19 | $882.7K | 12.1K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11042 | Removal of skin and tissue first 20 sq cm or less | 25.3K | $1.7M | $66.56 | 4.39x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 24.1K | $1.3M | $54.11 | 3.07x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 7.4K | $1.2M | $160.15 | 3.68x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 6.4K | $471.0K | $73.20 | 3.06x |
| 99183 | Management and supervision of oxygen chamber therapy per session | 3.1K | $266.0K | $87.14 | 3.20x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 2.3K | $156.2K | $67.05 | 3.10x |
| 17250 | Application of chemical agent to excessive wound tissue | 3.3K | $142.7K | $43.57 | 5.08x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.1K | $113.3K | $101.50 | 3.02x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 3.2K | $106.4K | $32.83 | 3.10x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 310 | $72.9K | $235.03 | 3.39x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 380 | $48.8K | $128.41 | 3.02x |
| 97597 | Removal of tissue from wounds per session | 980 | $43.5K | $44.34 | 4.69x |
| 11045 | Removal of skin and tissue | 1.8K | $42.5K | $23.18 | 3.42x |
| 11046 | Removal of skin and/or muscle | 686 | $35.7K | $52.11 | 3.66x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 405 | $21.9K | $54.15 | 3.08x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 286 | $15.0K | $52.46 | 3.07x |
| 15271 | Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) | 196 | $12.5K | $63.85 | 5.17x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 342 | $12.4K | $36.24 | 2.95x |
| 15275 | Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less) | 157 | $11.8K | $75.38 | 4.38x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 633 | $11.3K | $17.88 | 3.19x |
This provider submits charges 3.67 times higher than what Medicare actually pays.
A markup ratio of 3.67x means for every $100 Medicare pays, this provider initially charges $367. 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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