This provider's $9.2M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
Medicare payments to this provider grew 32828% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5881% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $50.91 | $18.37 | 2.77x | $32.54 | $10.2K | 556 | 6 |
| 2015 | $98.13 | $25.32 | 3.88x | $72.81 | $13.3K | 527 | 8 |
| 2016 | $113.59 | $23.10 | 4.92x | $90.49 | $11.8K | 511 | 7 |
| 2017 | $88.31 | $18.13 | 4.87x | $70.18 | $13.9K | 764 | 5 |
| 2018 | $52.56 | $13.23 | 3.97x | $39.33 | $21.1K | 1.6K | 8 |
| 2019 | $335.40 | $129.15 | 2.60x | $206.25 | $1.3M | 9.8K | 14 |
| 2020 | $694.51 | $315.37 | 2.20x | $379.14 | $1.9M | 6.0K | 12 |
| 2021 | $585.37 | $265.14 | 2.21x | $320.23 | $1.5M | 5.5K | 10 |
| 2022 | $457.39 | $271.93 | 1.68x | $185.46 | $1.1M | 4.2K | 13 |
| 2023 | $420.48 | $261.22 | 1.61x | $159.26 | $3.4M | 12.9K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4159 | Affinity, per square centimeter | 2.7K | $2.3M | $848.00 | 2.19x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 3.0K | $2.1M | $691.82 | 1.48x |
| Q4262 | Dual layer impax membrane, per square centimeter | 2.0K | $1.9M | $992.03 | 1.52x |
| Q4163 | Woundex, bioskin, per square centimeter | 7.3K | $1.1M | $155.73 | 2.57x |
| Q4197 | Puraply xt, per square centimeter | 1.9K | $396.1K | $208.47 | 1.68x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 4.9K | $370.0K | $76.07 | 2.75x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.1K | $172.8K | $54.92 | 2.32x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.9K | $127.1K | $67.41 | 2.92x |
| Q4178 | Floweramniopatch, per square centimeter | 322 | $124.0K | $385.18 | 2.41x |
| Q4254 | Novafix dl, per square centimeter | 328 | $123.9K | $377.83 | 2.61x |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 3.3K | $88.9K | $27.16 | 2.66x |
| J0875 | Injection, dalbavancin, 5 mg | 6.0K | $68.2K | $11.36 | 2.91x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 604 | $55.2K | $91.36 | 3.25x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 490 | $46.6K | $95.14 | 2.76x |
| 97610 | Therapy procedure using ultrasound | 165 | $44.5K | $269.43 | 3.76x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 265 | $27.5K | $103.62 | 2.56x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 178 | $20.7K | $116.33 | 2.14x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 213 | $12.9K | $60.73 | 3.10x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 61 | $12.6K | $205.83 | 2.67x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 74 | $10.8K | $145.41 | 2.76x |
This provider submits charges 1.99 times higher than what Medicare actually pays.
A markup ratio of 1.99x means for every $100 Medicare pays, this provider initially charges $199. 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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