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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Sudhir Rao
⚕️
MDIndividual

Sudhir Rao, M.D.

NPI: 1629103759
Mount Airy, MD
10 years of data
Interventional Pain Management
$5.8M
Total Payments
33.3K
Beneficiaries
90.8K
Services
11.79x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$5.8M
Specialty median$206.2K

📋 Key Findings

1Billed $5.8M over 10 years
211.79x markup ratio (above median)
398th percentile in Interventional Pain Management by payments
4Payments surged 84% in 2015
520 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $5.8M in total Medicare payments ranks in the 98th percentile of Interventional Pain Management providers nationally.

Their average markup ratio of 11.79x is significantly above the specialty median of 5.0x.

Medicare payments to this provider grew 138% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 84% in 2015

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$1.1K$137.497.65x$914.90$264.7K2.6K1.2K
2015$2.1K$81.1326.45x$2.1K$487.9K6.4K3.1K
2016$2.5K$95.0925.88x$2.4K$894.0K12.8K4.8K
2017$2.5K$87.9728.61x$2.4K$562.8K8.2K3.4K
2018$2.0K$80.9224.64x$1.9K$708.2K10.6K3.8K
2019$1.9K$74.9524.76x$1.8K$448.0K7.1K2.4K
2020$1.4K$70.7720.39x$1.4K$432.7K8.0K3.1K
2021$1.5K$77.6119.26x$1.4K$747.4K13.8K4.2K
2022$2.1K$83.2725.76x$2.1K$632.3K10.5K4.0K
2023$1.5K$88.0016.93x$1.4K$629.3K10.9K3.3K

Top Procedures (20)

80307Testing for presence of drug⚠ 7.1x markup
$1.8M
28.3K services$63.14/svc7.13x markup
99214Established patient office or other outpatient, visit typically 25 minutes⚠ 9.4x markup
$903.4K
10.8K services$83.65/svc9.40x markup
99213Established patient office or other outpatient visit, typically 15 minutes⚠ 14.1x markup
$810.0K
15.2K services$53.16/svc14.11x markup
64483Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance⚠ 18.2x markup
$321.5K
2.0K services$159.06/svc18.19x markup
99490Chronic care management services at least 20 minutes per calendar month⚠ 8.5x markup
$273.5K
6.7K services$40.94/svc8.49x markup
G0479Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when⚠ 6.5x markup
$216.2K
2.8K services$76.38/svc6.54x markup
99439Chronic care management services, each additional 20 minutes of clinical staff time per calendar month⚠ 13.0x markup
$199.4K
5.8K services$34.58/svc13.01x markup
99204New patient office or other outpatient visit, typically 45 minutes⚠ 8.3x markup
$175.2K
1.4K services$124.73/svc8.26x markup
99205New patient office or other outpatient visit, typically 60 minutes⚠ 6.9x markup
$119.3K
774 services$154.10/svc6.89x markup
99484Care management services for behavioral health conditions, at least 20 minutes clinical staff time⚠ 13.0x markup
$106.6K
3.1K services$34.51/svc13.04x markup
64635Destruction of lower or sacral spinal facet joint nerves using imaging guidance⚠ 12.4x markup
$106.1K
457 services$232.25/svc12.43x markup
64493Injections of lower or sacral spine facet joint using imaging guidance⚠ 25.8x markup
$70.8K
639 services$110.76/svc25.80x markup
G0431Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter⚠ 5.1x markup
$59.3K
613 services$96.80/svc5.06x markup
99493Subsequent psychiatric collaborative care management, first 60 minutes in subsequent month of behavioral health care manager activities⚠ 9.3x markup
$53.3K
472 services$112.96/svc9.30x markup
95923Testing of autonomic (sympathetic) nervous system function⚠ 7.4x markup
$51.3K
431 services$119.10/svc7.40x markup
63650Implantation of spinal neurostimulator electrodes, accessed through the skin⚠ 26.8x markup
$42.2K
90 services$469.44/svc26.80x markup
64484Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance⚠ 53.1x markup
$40.5K
750 services$54.01/svc53.11x markup
64636Destruction of lower or sacral spinal facet joint nerves with imaging guidance⚠ 31.5x markup
$39.6K
444 services$89.28/svc31.52x markup
93922Ultrasound study of arteries of both arms and legs⚠ 11.9x markup
$39.4K
561 services$70.25/svc11.88x markup
64494Injections of lower or sacral spine facet joint using imaging guidance⚠ 48.5x markup
$37.0K
626 services$59.10/svc48.53x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
80307Testing for presence of drug28.3K$1.8M$63.147.13x
99214Established patient office or other outpatient, visit typically 25 minutes10.8K$903.4K$83.659.40x
99213Established patient office or other outpatient visit, typically 15 minutes15.2K$810.0K$53.1614.11x
64483Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance2.0K$321.5K$159.0618.19x
99490Chronic care management services at least 20 minutes per calendar month6.7K$273.5K$40.948.49x
G0479Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when2.8K$216.2K$76.386.54x
99439Chronic care management services, each additional 20 minutes of clinical staff time per calendar month5.8K$199.4K$34.5813.01x
99204New patient office or other outpatient visit, typically 45 minutes1.4K$175.2K$124.738.26x
99205New patient office or other outpatient visit, typically 60 minutes774$119.3K$154.106.89x
99484Care management services for behavioral health conditions, at least 20 minutes clinical staff time3.1K$106.6K$34.5113.04x
64635Destruction of lower or sacral spinal facet joint nerves using imaging guidance457$106.1K$232.2512.43x
64493Injections of lower or sacral spine facet joint using imaging guidance639$70.8K$110.7625.80x
G0431Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter613$59.3K$96.805.06x
99493Subsequent psychiatric collaborative care management, first 60 minutes in subsequent month of behavioral health care manager activities472$53.3K$112.969.30x
95923Testing of autonomic (sympathetic) nervous system function431$51.3K$119.107.40x
63650Implantation of spinal neurostimulator electrodes, accessed through the skin90$42.2K$469.4426.80x
64484Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance750$40.5K$54.0153.11x
64636Destruction of lower or sacral spinal facet joint nerves with imaging guidance444$39.6K$89.2831.52x
93922Ultrasound study of arteries of both arms and legs561$39.4K$70.2511.88x
64494Injections of lower or sacral spine facet joint using imaging guidance626$37.0K$59.1048.53x

Markup Analysis

Charge-to-Payment Ratio

11.79x

This provider submits charges 11.79 times higher than what Medicare actually pays.

What This Means

A markup ratio of 11.79x means for every $100 Medicare pays, this provider initially charges $1179. This is higher than the national average.

Location

Mount Airy, MD

Provider Verification

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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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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