This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Physical Therapist in Private Practice 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 |
|---|---|---|---|---|---|---|---|
| 2023 | $1.2K | $959.61 | 1.29x | $274.54 | $3.6M | 3.8K | 4 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 2.3K | $2.1M | $915.38 | 1.28x |
| Q4281 | Barrera sl or barrera dl, per square centimeter | 1.3K | $1.5M | $1.2K | 1.28x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 206 | $24.9K | $121.09 | 2.56x |
| 15272 | Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less | 51 | $1.0K | $20.58 | 2.43x |
This provider submits charges 1.29 times higher than what Medicare actually pays.
A markup ratio of 1.29x means for every $100 Medicare pays, this provider initially charges $129. This is lower 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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