This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Emergency Medicine providers nationally.
Medicare payments to this provider grew 6396% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1342% in 2019
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $145.00 | $37.21 | 3.90x | $107.79 | $14.0K | 253 | 249 |
| 2019 | $113.51 | $78.88 | 1.44x | $34.63 | $201.7K | 3.1K | 1.0K |
| 2020 | $182.54 | $125.18 | 1.46x | $57.36 | $898.6K | 8.1K | 2.7K |
| 2021 | $196.08 | $138.02 | 1.42x | $58.06 | $1.0M | 9.7K | 3.5K |
| 2022 | $186.66 | $134.54 | 1.39x | $52.12 | $945.1K | 9.0K | 3.2K |
| 2023 | $181.78 | $134.99 | 1.35x | $46.79 | $908.7K | 8.3K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 12.9K | $993.5K | $77.07 | 1.36x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 4.1K | $736.1K | $181.18 | 1.46x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 5.4K | $617.1K | $113.81 | 1.34x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 2.0K | $524.6K | $263.77 | 1.35x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.4K | $186.9K | $136.00 | 1.38x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.6K | $168.4K | $104.65 | 1.36x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 2.6K | $149.9K | $56.81 | 1.37x |
| 10160 | Aspiration of abscess, blood accumulation, blister, or cyst | 1.3K | $126.0K | $96.14 | 1.54x |
| 11047 | Removal of skin and bone | 1.0K | $105.4K | $103.92 | 1.34x |
| 11046 | Removal of skin and/or muscle | 1.4K | $85.4K | $62.12 | 1.34x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.4K | $83.4K | $34.88 | 1.45x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 808 | $71.9K | $88.98 | 1.63x |
| 49450 | Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin | 76 | $40.9K | $538.14 | 1.35x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 411 | $29.0K | $70.68 | 1.44x |
| 10060 | Drainage of abscess | 281 | $24.4K | $86.95 | 1.62x |
| 17250 | Application of chemical agent to excessive wound tissue | 293 | $19.8K | $67.69 | 1.41x |
| 10061 | Drainage of multiple abscess | 74 | $11.8K | $159.12 | 1.48x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 108 | $6.9K | $63.54 | 3.31x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 105 | $6.7K | $63.96 | 3.28x |
| 11045 | Removal of skin and tissue | 141 | $4.9K | $34.46 | 1.35x |
This provider submits charges 1.4 times higher than what Medicare actually pays.
A markup ratio of 1.4x means for every $100 Medicare pays, this provider initially charges $140. This is lower 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.
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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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