This provider's $7.3M in total Medicare payments ranks in the 99th percentile of Oral Surgery (Dentist only) providers nationally.
Their average markup ratio of 6.79x is significantly above the specialty median of 2.7x.
Medicare payments to this provider grew 210% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 84% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $2.3K | $250.94 | 9.35x | $2.1K | $244.2K | 1.1K | 936 |
| 2015 | $2.4K | $262.54 | 8.97x | $2.1K | $421.8K | 2.0K | 1.6K |
| 2016 | $2.6K | $273.27 | 9.57x | $2.3K | $427.9K | 2.1K | 1.8K |
| 2017 | $3.0K | $364.91 | 8.20x | $2.6K | $788.1K | 3.4K | 2.9K |
| 2018 | $2.8K | $347.19 | 8.09x | $2.5K | $825.1K | 3.4K | 3.0K |
| 2019 | $3.0K | $423.76 | 7.16x | $2.6K | $675.1K | 2.5K | 2.2K |
| 2020 | $1.5K | $338.29 | 4.37x | $1.1K | $807.8K | 3.4K | 3.1K |
| 2021 | $1.0K | $300.22 | 3.37x | $712.24 | $1.3M | 5.3K | 4.5K |
| 2022 | $1.2K | $338.60 | 3.63x | $891.22 | $1.1M | 4.5K | 3.9K |
| 2023 | $1.4K | $355.09 | 3.81x | $998.73 | $757.6K | 3.0K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 21215 | Repair of lower jaw bone with bone graft | 793 | $987.0K | $1.2K | 4.37x |
| 21210 | Repair of nasal or cheek bone with bone graft | 1.2K | $747.0K | $646.17 | 5.81x |
| 21048 | Oral removal of upper jaw bone growth or cyst | 786 | $513.1K | $652.78 | 5.79x |
| 11012 | Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation | 1.6K | $480.5K | $308.78 | 11.63x |
| 21145 | Reconstruction of midface bones with bone graft | 318 | $427.8K | $1.3K | 2.86x |
| 21046 | Oral removal of lower jaw bone growth or cyst | 693 | $419.4K | $605.20 | 4.64x |
| 20680 | Removal of deep bone implant | 1.2K | $318.0K | $274.15 | 3.17x |
| 21146 | Reconstruction of midface bones with bone graft | 191 | $274.6K | $1.4K | 3.77x |
| 21445 | Open treatment of broken jaw or cheek bone | 721 | $232.1K | $321.85 | 11.04x |
| 21208 | Incision and repair of bony defect of cheek bone with repositioning of bony segment | 285 | $222.5K | $780.81 | 3.96x |
| 21025 | Removal of lower jaw bone | 521 | $179.8K | $345.15 | 7.64x |
| 21461 | Open treatment of broken jaw bone | 289 | $177.1K | $612.78 | 9.03x |
| 31030 | Incision of nasal sinus | 598 | $142.9K | $238.93 | 14.50x |
| 21198 | Incision of lower jaw bone | 257 | $142.1K | $552.94 | 3.36x |
| 21047 | External removal of lower jaw bone growth or cyst | 199 | $140.7K | $707.24 | 2.81x |
| 21206 | Incision and repositioning of cheek bone | 277 | $133.0K | $480.27 | 3.85x |
| 12052 | Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth | 1.3K | $129.9K | $101.26 | 21.23x |
| 21026 | Removal of facial bones | 516 | $118.5K | $229.75 | 9.93x |
| 30580 | Repair of abnormal drainage tract between two nasal sinuses | 492 | $116.9K | $237.51 | 7.69x |
| 21049 | External removal of upper jaw bone growth or cyst | 197 | $113.8K | $577.46 | 3.22x |
This provider submits charges 6.79 times higher than what Medicare actually pays.
A markup ratio of 6.79x means for every $100 Medicare pays, this provider initially charges $679. 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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