This provider's $5.7M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $201.45 | $76.05 | 2.65x | $125.40 | $453.1K | 5.1K | 2.4K |
| 2015 | $214.16 | $84.70 | 2.53x | $129.46 | $500.0K | 6.0K | 2.4K |
| 2016 | $203.62 | $83.44 | 2.44x | $120.18 | $529.8K | 6.6K | 2.4K |
| 2017 | $187.56 | $78.48 | 2.39x | $109.08 | $614.7K | 7.5K | 2.4K |
| 2018 | $202.88 | $90.26 | 2.25x | $112.62 | $744.0K | 8.5K | 2.7K |
| 2019 | $194.87 | $88.35 | 2.21x | $106.52 | $645.1K | 7.4K | 2.3K |
| 2020 | $178.93 | $94.65 | 1.89x | $84.28 | $690.0K | 8.3K | 2.3K |
| 2021 | $175.54 | $89.98 | 1.95x | $85.56 | $578.7K | 7.0K | 2.2K |
| 2022 | $187.72 | $96.22 | 1.95x | $91.50 | $447.3K | 5.4K | 1.7K |
| 2023 | $187.70 | $91.24 | 2.06x | $96.46 | $483.3K | 5.2K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 25.8K | $2.2M | $83.86 | 2.15x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 25.5K | $1.5M | $57.99 | 1.83x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 4.9K | $869.2K | $178.19 | 1.97x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.3K | $689.5K | $159.64 | 1.87x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.2K | $252.8K | $79.71 | 2.16x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 690 | $49.7K | $72.07 | 1.82x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 292 | $44.1K | $151.02 | 2.00x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 273 | $31.0K | $113.71 | 1.83x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 415 | $17.2K | $41.46 | 2.05x |
| 94729 | Measurement of lung diffusing capacity | 389 | $16.1K | $41.34 | 2.05x |
| 94727 | Determination of lung volumes using gas dilution or washout | 390 | $12.7K | $32.56 | 2.45x |
| 99292 | Critical care delivery critically ill or injured patient | 117 | $10.6K | $90.54 | 2.02x |
| 31622 | Diagnostic examination of lung airways using an endoscope | 87 | $9.9K | $113.48 | 4.21x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 80 | $8.1K | $100.91 | 3.81x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 240 | $7.5K | $31.32 | 1.87x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 55 | $5.3K | $97.10 | 3.72x |
| 31500 | Emergent insertion of breathing tube into windpipe cartilage using an endoscope | 37 | $4.0K | $108.96 | 1.60x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 55 | $3.0K | $54.63 | 1.83x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 39 | $2.8K | $72.74 | 1.90x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 25 | $2.6K | $104.76 | 1.86x |
This provider submits charges 2.01 times higher than what Medicare actually pays.
A markup ratio of 2.01x means for every $100 Medicare pays, this provider initially charges $201. 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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