This provider averages 131 services per working day
Based on 163.6K total services over 5 years (250 working days/year). Learn about impossible service volumes →
This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Physical Therapist in Private Practice providers nationally.
Averaging 131 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 232% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 76% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $78.87 | $26.23 | 3.01x | $52.64 | $302.2K | 13.8K | 1.8K |
| 2020 | $103.24 | $28.76 | 3.59x | $74.48 | $407.0K | 18.0K | 1.7K |
| 2021 | $128.11 | $35.65 | 3.59x | $92.46 | $717.8K | 31.2K | 2.2K |
| 2022 | $126.71 | $29.92 | 4.23x | $96.79 | $861.1K | 45.1K | 2.8K |
| 2023 | $107.41 | $32.27 | 3.33x | $75.14 | $1.0M | 55.5K | 3.2K |
| 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 | 43.5K | $959.4K | $22.06 | 4.16x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 47.7K | $838.0K | $17.56 | 4.48x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 27.9K | $554.1K | $19.85 | 4.61x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 24.2K | $396.8K | $16.39 | 3.67x |
| 97116 | Walking training to 1 or more areas, each 15 minutes | 12.3K | $213.7K | $17.37 | 3.19x |
| 97161 | Evaluation of physical therapy, typically 20 minutes | 2.3K | $162.0K | $71.01 | 2.82x |
| 97162 | Evaluation of physical therapy, typically 30 minutes | 1.2K | $91.5K | $74.18 | 4.60x |
| 97535 | Self-care or home management training, each 15 minutes | 3.1K | $57.4K | $18.69 | 2.82x |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 1.2K | $9.1K | $7.77 | 3.21x |
| 97164 | Re-evaluation of physical therapy, typically 20 minutes | 148 | $7.7K | $51.96 | 3.48x |
| 97035 | Application of ultrasound to 1 or more areas, each 15 minutes | 64 | $547.80 | $8.56 | 4.76x |
This provider submits charges 4.11 times higher than what Medicare actually pays.
A markup ratio of 4.11x means for every $100 Medicare pays, this provider initially charges $411. 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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