This provider averages 70 services per working day
Based on 174.1K total services over 10 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 70 services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 67% in 2016
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 | $78.74 | $24.71 | 3.19x | $54.03 | $156.4K | 7.6K | 1.3K |
| 2015 | $78.75 | $23.70 | 3.32x | $55.05 | $179.9K | 9.5K | 1.5K |
| 2016 | $78.75 | $23.64 | 3.33x | $55.11 | $300.4K | 16.4K | 2.2K |
| 2017 | $78.75 | $24.46 | 3.22x | $54.29 | $374.5K | 19.7K | 3.2K |
| 2018 | $78.75 | $25.53 | 3.08x | $53.22 | $586.7K | 29.8K | 4.4K |
| 2019 | $81.00 | $25.85 | 3.13x | $55.15 | $722.9K | 37.0K | 5.1K |
| 2020 | $81.82 | $25.28 | 3.24x | $56.54 | $346.0K | 18.2K | 2.9K |
| 2021 | $90.00 | $32.90 | 2.74x | $57.10 | $252.9K | 13.0K | 2.0K |
| 2022 | $85.50 | $29.69 | 2.88x | $55.81 | $164.7K | 9.3K | 1.6K |
| 2023 | $85.50 | $26.92 | 3.18x | $58.58 | $232.5K | 13.5K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 53.0K | $965.3K | $18.20 | 2.47x |
| 97113 | Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes | 29.5K | $650.7K | $22.09 | 2.04x |
| 97530 | Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes | 17.3K | $400.5K | $23.11 | 1.95x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 20.5K | $334.0K | $16.31 | 2.76x |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 36.7K | $272.6K | $7.43 | 6.05x |
| 97164 | Re-evaluation of physical therapy, typically 20 minutes | 5.6K | $241.3K | $43.28 | 4.16x |
| 97162 | Evaluation of physical therapy, typically 30 minutes | 2.7K | $161.3K | $58.82 | 3.06x |
| 97161 | Evaluation of physical therapy, typically 20 minutes | 2.0K | $121.6K | $61.56 | 2.92x |
| 97001 | Physical therapy evaluation | 1.1K | $57.6K | $52.53 | 3.43x |
| 97002 | Physical therapy re-evaluation | 1.2K | $36.3K | $29.67 | 6.07x |
| 97116 | Walking training to 1 or more areas, each 15 minutes | 1.6K | $25.9K | $16.39 | 2.75x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 1.1K | $25.6K | $23.87 | 1.88x |
| 97535 | Self-care or home management training, each 15 minutes | 784 | $17.2K | $21.92 | 2.05x |
| 97018 | Application of hot wax bath to 1 or more areas | 703 | $2.6K | $3.75 | 11.99x |
| 97163 | Evaluation of physical therapy, typically 45 minutes | 34 | $2.1K | $60.40 | 2.98x |
| 97012 | Application of mechanical traction to 1 or more areas | 220 | $2.0K | $9.18 | 4.90x |
| 97035 | Application of ultrasound to 1 or more areas, each 15 minutes | 45 | $350.00 | $7.78 | 5.79x |
This provider submits charges 2.88 times higher than what Medicare actually pays.
A markup ratio of 2.88x means for every $100 Medicare pays, this provider initially charges $288. 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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