This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation providers nationally.
Medicare payments to this provider grew 510% from 2016 to 2023.
61% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 450% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $192.50 | $93.08 | 2.07x | $99.42 | $80.5K | 1.0K | 400 |
| 2017 | $171.62 | $75.87 | 2.26x | $95.75 | $443.2K | 6.1K | 2.2K |
| 2018 | $195.14 | $86.12 | 2.27x | $109.02 | $490.2K | 6.8K | 2.3K |
| 2019 | $194.93 | $82.26 | 2.37x | $112.67 | $684.1K | 10.4K | 2.6K |
| 2020 | $195.00 | $83.60 | 2.33x | $111.40 | $647.4K | 9.8K | 2.2K |
| 2021 | $240.87 | $92.98 | 2.59x | $147.89 | $538.3K | 8.3K | 2.0K |
| 2022 | $241.67 | $86.56 | 2.79x | $155.11 | $531.2K | 8.6K | 2.1K |
| 2023 | $218.75 | $78.01 | 2.80x | $140.74 | $491.3K | 7.3K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 42.4K | $2.4M | $56.35 | 2.49x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.1K | $642.3K | $155.64 | 1.97x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.9K | $477.2K | $81.00 | 2.21x |
| 99238 | Hospital discharge day management, 30 minutes or less | 4.3K | $243.5K | $56.89 | 3.39x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.1K | $110.0K | $100.14 | 3.00x |
| 99239 | Hospital discharge day management, more than 30 minutes | 429 | $35.3K | $82.34 | 2.86x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 92 | $6.5K | $71.01 | 2.46x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 45 | $2.8K | $61.74 | 2.02x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 14 | $424.62 | $30.33 | 2.47x |
This provider submits charges 2.45 times higher than what Medicare actually pays.
A markup ratio of 2.45x means for every $100 Medicare pays, this provider initially charges $245. 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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