This provider's $5.4M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation 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 | $135.61 | $69.35 | 1.96x | $66.26 | $556.1K | 9.1K | 2.7K |
| 2015 | $134.28 | $67.94 | 1.98x | $66.34 | $552.4K | 9.6K | 2.6K |
| 2016 | $137.15 | $65.57 | 2.09x | $71.58 | $681.0K | 11.3K | 3.1K |
| 2017 | $157.36 | $76.99 | 2.04x | $80.37 | $602.6K | 9.9K | 2.8K |
| 2018 | $148.47 | $78.06 | 1.90x | $70.41 | $568.9K | 9.8K | 2.8K |
| 2019 | $146.13 | $71.53 | 2.04x | $74.60 | $529.6K | 9.2K | 2.9K |
| 2020 | $152.99 | $75.64 | 2.02x | $77.35 | $418.6K | 7.1K | 2.0K |
| 2021 | $176.20 | $77.49 | 2.27x | $98.71 | $491.1K | 7.4K | 1.7K |
| 2022 | $163.85 | $72.54 | 2.26x | $91.31 | $492.8K | 7.2K | 2.1K |
| 2023 | $178.31 | $71.81 | 2.48x | $106.50 | $514.9K | 7.4K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 14.2K | $1.1M | $79.62 | 3.45x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 18.8K | $1.1M | $57.60 | 1.72x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.3K | $887.9K | $95.82 | 1.68x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 5.9K | $409.8K | $69.09 | 2.06x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 3.9K | $295.3K | $76.48 | 1.63x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 5.2K | $281.8K | $53.80 | 5.36x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.5K | $266.2K | $59.68 | 1.57x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.2K | $263.7K | $50.36 | 2.75x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.5K | $212.9K | $138.32 | 1.67x |
| 76881 | Ultrasound of leg or arm | 2.2K | $165.9K | $75.98 | 2.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $134.5K | $132.55 | 1.75x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 8.1K | $78.4K | $9.69 | 1.77x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 632 | $67.5K | $106.82 | 1.56x |
| 20606 | Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance | 382 | $26.6K | $69.64 | 3.51x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 5.7K | $23.0K | $4.04 | 1.63x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 222 | $19.3K | $87.12 | 1.49x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 156 | $16.6K | $106.26 | 3.76x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 198 | $7.0K | $35.54 | 1.97x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 132 | $5.8K | $43.87 | 1.71x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 94 | $5.7K | $60.43 | 1.50x |
This provider submits charges 2.37 times higher than what Medicare actually pays.
A markup ratio of 2.37x means for every $100 Medicare pays, this provider initially charges $237. 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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