This provider's $7.2M in total Medicare payments ranks in the 99th percentile of General Surgery providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 93% in 2016
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 | $233.04 | $96.03 | 2.43x | $137.01 | $648.6K | 7.2K | 462 |
| 2015 | $224.77 | $80.04 | 2.81x | $144.73 | $363.2K | 4.2K | 371 |
| 2016 | $282.35 | $100.64 | 2.81x | $181.71 | $700.9K | 8.9K | 496 |
| 2017 | $289.40 | $98.23 | 2.95x | $191.17 | $713.0K | 9.5K | 592 |
| 2018 | $225.37 | $77.89 | 2.89x | $147.48 | $945.0K | 13.0K | 1.1K |
| 2019 | $234.09 | $93.72 | 2.50x | $140.37 | $869.6K | 10.7K | 960 |
| 2020 | $219.76 | $103.81 | 2.12x | $115.95 | $681.8K | 7.0K | 1.0K |
| 2021 | $221.95 | $84.83 | 2.62x | $137.12 | $722.2K | 8.9K | 879 |
| 2022 | $209.42 | $76.07 | 2.75x | $133.35 | $832.7K | 11.7K | 1.1K |
| 2023 | $249.53 | $82.62 | 3.02x | $166.91 | $766.3K | 13.6K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99349 | Established patient home visit, typically 40 minutes | 17.1K | $1.8M | $102.80 | 2.77x |
| 97597 | Removal of tissue from wounds per session | 36.3K | $1.7M | $48.22 | 2.59x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 13.8K | $1.2M | $84.70 | 2.55x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 5.8K | $901.9K | $155.71 | 1.83x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 4.2K | $740.7K | $176.53 | 2.15x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.2K | $184.5K | $157.81 | 2.37x |
| 97598 | Removal of tissue from wounds per session | 7.4K | $165.7K | $22.38 | 5.63x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.0K | $119.0K | $59.22 | 4.21x |
| 99354 | Prolonged office or other outpatient service first hour | 952 | $77.6K | $81.49 | 2.10x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 871 | $64.9K | $74.55 | 2.44x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 1.7K | $60.9K | $35.53 | 8.44x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 348 | $38.1K | $109.42 | 2.28x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 817 | $35.7K | $43.70 | 4.10x |
| 99344 | New patient home visit, typically 60 minutes | 210 | $29.2K | $138.97 | 2.25x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 293 | $21.9K | $74.81 | 2.67x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 105 | $17.8K | $169.95 | 1.48x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 185 | $16.1K | $87.26 | 3.44x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 266 | $13.7K | $51.52 | 1.36x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 56 | $12.5K | $223.77 | 1.34x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 82 | $9.1K | $111.51 | 2.43x |
This provider submits charges 2.63 times higher than what Medicare actually pays.
A markup ratio of 2.63x means for every $100 Medicare pays, this provider initially charges $263. 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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