This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Plastic and Reconstructive Surgery 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 | $502.28 | $226.84 | 2.21x | $275.44 | $516.1K | 2.0K | 1.8K |
| 2015 | $496.04 | $219.03 | 2.26x | $277.01 | $504.8K | 2.0K | 1.8K |
| 2016 | $530.46 | $226.62 | 2.34x | $303.84 | $469.5K | 2.0K | 1.8K |
| 2017 | $525.16 | $215.11 | 2.44x | $310.05 | $462.2K | 2.1K | 1.8K |
| 2018 | $480.37 | $200.54 | 2.40x | $279.83 | $428.4K | 2.0K | 1.7K |
| 2019 | $480.88 | $211.52 | 2.27x | $269.36 | $454.7K | 2.1K | 1.8K |
| 2020 | $482.73 | $216.05 | 2.23x | $266.68 | $401.6K | 1.8K | 1.6K |
| 2021 | $474.63 | $217.43 | 2.18x | $257.20 | $491.1K | 1.9K | 1.6K |
| 2022 | $477.90 | $214.37 | 2.23x | $263.53 | $601.7K | 2.2K | 1.8K |
| 2023 | $509.12 | $214.27 | 2.38x | $294.85 | $663.9K | 2.4K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 17108 | Destruction of skin growth (over 50.0 sq centimeters) | 1.8K | $831.1K | $471.13 | 2.55x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 1.4K | $776.7K | $558.77 | 2.14x |
| 14040 | Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 836 | $452.3K | $541.07 | 1.80x |
| 14021 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs | 617 | $399.0K | $646.70 | 1.66x |
| 14041 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 446 | $306.8K | $687.84 | 2.21x |
| 12032 | Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs | 1.8K | $263.8K | $149.61 | 2.39x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $205.0K | $123.88 | 1.54x |
| 11606 | Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs | 533 | $154.0K | $289.02 | 1.68x |
| 12051 | Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth | 936 | $140.4K | $149.95 | 1.98x |
| 12052 | Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth | 953 | $140.2K | $147.08 | 3.33x |
| 14020 | Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs | 259 | $128.4K | $495.74 | 1.61x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 762 | $117.3K | $154.00 | 2.08x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.2K | $99.2K | $81.68 | 1.85x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 107 | $79.2K | $740.12 | 2.28x |
| 11406 | Removal of growth (4.0 centimeters) of the trunk, arms, or legs | 329 | $68.1K | $206.99 | 1.65x |
| 11644 | Removal of malignant growth (3.1 to 4.0 centimeters) of the face, ears, eyelids, nose, or lips | 299 | $60.4K | $202.05 | 2.36x |
| 11643 | Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips | 382 | $56.0K | $146.56 | 2.58x |
| 14301 | Tissue transfer repair of wound (30.1 to 60.0 sq centimeters) | 69 | $55.0K | $797.76 | 2.83x |
| 12031 | Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs | 408 | $50.1K | $122.87 | 2.09x |
| 12042 | Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals | 330 | $45.8K | $138.84 | 2.57x |
This provider submits charges 2.24 times higher than what Medicare actually pays.
A markup ratio of 2.24x means for every $100 Medicare pays, this provider initially charges $224. 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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