This provider averages 57 services per working day
Based on 141.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Physical Therapist in Private Practice providers nationally.
Averaging 57 services per working day raises questions about billing patterns.
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 | $46.20 | $30.56 | 1.51x | $15.64 | $321.5K | 13.4K | 1.5K |
| 2015 | $46.56 | $30.29 | 1.54x | $16.27 | $342.5K | 14.4K | 1.4K |
| 2016 | $47.01 | $30.66 | 1.53x | $16.35 | $394.6K | 16.4K | 1.5K |
| 2017 | $62.44 | $42.55 | 1.47x | $19.89 | $352.4K | 14.5K | 1.4K |
| 2018 | $56.90 | $39.18 | 1.45x | $17.72 | $360.7K | 14.4K | 1.4K |
| 2019 | $56.90 | $39.29 | 1.45x | $17.61 | $378.5K | 15.0K | 1.6K |
| 2020 | $57.04 | $40.49 | 1.41x | $16.55 | $291.5K | 11.4K | 1.3K |
| 2021 | $57.02 | $40.28 | 1.42x | $16.74 | $339.2K | 13.1K | 1.4K |
| 2022 | $57.06 | $39.32 | 1.45x | $17.74 | $372.0K | 14.6K | 1.5K |
| 2023 | $50.22 | $31.12 | 1.61x | $19.10 | $358.0K | 14.7K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 97530 | Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes | 44.7K | $1.2M | $27.50 | 1.47x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 45.9K | $969.0K | $21.13 | 1.78x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 33.2K | $777.9K | $23.42 | 1.67x |
| 97116 | Walking training to 1 or more areas, each 15 minutes | 14.4K | $290.0K | $20.13 | 1.62x |
| 97162 | Evaluation of physical therapy, typically 30 minutes | 1.7K | $120.8K | $73.12 | 1.36x |
| 97001 | Physical therapy evaluation | 1.1K | $67.3K | $63.89 | 1.33x |
| 97163 | Evaluation of physical therapy, typically 45 minutes | 732 | $51.8K | $70.79 | 1.35x |
| 97161 | Evaluation of physical therapy, typically 20 minutes | 50 | $3.4K | $67.51 | 1.41x |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 22 | $410.28 | $18.65 | 1.86x |
This provider submits charges 1.61 times higher than what Medicare actually pays.
A markup ratio of 1.61x means for every $100 Medicare pays, this provider initially charges $161. 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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