This provider's $5.5M in total Medicare payments ranks in the 99th percentile of Plastic and Reconstructive Surgery providers nationally.
Medicare payments to this provider grew 102% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 137% in 2020
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 | $444.01 | $88.98 | 4.99x | $355.03 | $320.7K | 3.5K | 749 |
| 2015 | $449.37 | $86.97 | 5.17x | $362.40 | $494.6K | 5.3K | 914 |
| 2016 | $463.60 | $94.39 | 4.91x | $369.21 | $409.8K | 4.5K | 726 |
| 2017 | $398.85 | $83.28 | 4.79x | $315.57 | $379.7K | 4.4K | 848 |
| 2018 | $459.45 | $111.00 | 4.14x | $348.45 | $448.5K | 3.9K | 712 |
| 2019 | $403.53 | $82.57 | 4.89x | $320.96 | $370.0K | 3.7K | 644 |
| 2020 | $398.99 | $84.60 | 4.72x | $314.39 | $876.1K | 8.1K | 1.1K |
| 2021 | $441.60 | $96.51 | 4.58x | $345.09 | $862.1K | 7.4K | 761 |
| 2022 | $510.70 | $109.94 | 4.65x | $400.76 | $700.0K | 5.9K | 694 |
| 2023 | $459.33 | $91.15 | 5.04x | $368.18 | $647.2K | 5.9K | 805 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 9.5K | $1.1M | $115.84 | 3.70x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 6.5K | $910.7K | $140.78 | 5.57x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 3.7K | $874.6K | $236.63 | 4.92x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 6.4K | $747.9K | $116.02 | 3.74x |
| 99349 | Established patient home visit, typically 40 minutes | 2.7K | $291.0K | $107.95 | 3.77x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.8K | $240.0K | $134.02 | 3.56x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 4.1K | $227.5K | $54.90 | 7.54x |
| 17250 | Application of chemical agent to excessive wound tissue | 3.1K | $174.0K | $55.37 | 5.20x |
| 11047 | Removal of skin and bone | 1.8K | $170.2K | $92.76 | 4.39x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.7K | $148.4K | $88.89 | 3.68x |
| 11046 | Removal of skin and/or muscle | 2.0K | $103.6K | $51.88 | 4.67x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 740 | $103.5K | $139.83 | 3.81x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 795 | $60.1K | $75.65 | 3.87x |
| 17000 | Destruction of skin growth | 1.3K | $55.5K | $42.41 | 5.48x |
| 11303 | Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs | 615 | $47.5K | $77.24 | 7.15x |
| 11055 | Removal of single thickened skin growth | 1.8K | $43.6K | $23.93 | 7.07x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 197 | $34.1K | $173.21 | 3.69x |
| 11056 | Removal of 2 to 4 thickened skin growths | 1.0K | $28.3K | $27.62 | 7.41x |
| 99327 | New patient assisted living visit, typically 60 minutes | 148 | $23.1K | $156.19 | 3.78x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 243 | $21.5K | $88.32 | 3.42x |
This provider submits charges 4.57 times higher than what Medicare actually pays.
A markup ratio of 4.57x means for every $100 Medicare pays, this provider initially charges $457. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Plastic and Reconstructive Surgery providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Johnson Lee, M.D. | Beverly Hills, CA | $37.6M | ⚠️ Flagged |
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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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