This provider's $5.8M 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.
Notable: Payments increased 50% in 2020
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 | $1.4K | $405.96 | 3.40x | $975.64 | $599.2K | 1.2K | 1.1K |
| 2015 | $702.86 | $476.40 | 1.48x | $226.46 | $653.8K | 1.3K | 1.2K |
| 2016 | $660.62 | $459.34 | 1.44x | $201.28 | $657.8K | 1.3K | 1.2K |
| 2017 | $682.42 | $457.66 | 1.49x | $224.76 | $389.6K | 716 | 686 |
| 2018 | $637.39 | $462.04 | 1.38x | $175.35 | $381.6K | 705 | 679 |
| 2019 | $800.32 | $476.88 | 1.68x | $323.44 | $364.5K | 701 | 655 |
| 2020 | $1.0K | $510.74 | 2.05x | $538.60 | $548.6K | 972 | 920 |
| 2021 | $957.05 | $487.78 | 1.96x | $469.27 | $728.0K | 1.3K | 1.2K |
| 2022 | $999.84 | $513.36 | 1.95x | $486.48 | $743.5K | 1.4K | 1.3K |
| 2023 | $1.1K | $514.05 | 2.15x | $589.73 | $750.4K | 1.4K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 14040 | Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 1.2K | $899.8K | $720.96 | 1.74x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 1.1K | $788.6K | $731.57 | 2.06x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 730 | $698.2K | $956.50 | 1.93x |
| 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 1.5K | $652.8K | $448.98 | 1.72x |
| 14020 | Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs | 974 | $652.2K | $669.60 | 1.83x |
| 13121 | Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs | 1.4K | $549.0K | $402.50 | 2.12x |
| 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 | 371 | $332.1K | $895.22 | 1.81x |
| 14021 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs | 338 | $283.8K | $839.60 | 2.14x |
| 13131 | Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 628 | $222.7K | $354.67 | 2.31x |
| 14000 | Tissue transfer repair of wound (10 sq centimeters or less) of the trunk | 209 | $124.8K | $596.90 | 1.60x |
| 13151 | Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips | 290 | $115.6K | $398.71 | 2.06x |
| 13101 | Repair of wound (2.6 to 7.5 centimeters) of trunk | 273 | $102.0K | $373.72 | 1.70x |
| 13152 | Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips | 196 | $94.4K | $481.69 | 1.92x |
| 14001 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the trunk | 117 | $92.1K | $787.01 | 1.84x |
| 12051 | Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth | 183 | $44.8K | $244.77 | 1.94x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 450 | $42.3K | $93.98 | 1.69x |
| 12031 | Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs | 146 | $32.2K | $220.45 | 2.21x |
| 14301 | Repair of wound by transferring skin, 30.1-60.0 sq cm | 28 | $29.7K | $1.1K | 3.30x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 492 | $23.4K | $47.52 | 2.61x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 201 | $13.1K | $65.35 | 1.73x |
This provider submits charges 1.92 times higher than what Medicare actually pays.
A markup ratio of 1.92x means for every $100 Medicare pays, this provider initially charges $192. 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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