This provider's $8.3M in total Medicare payments ranks in the 99th percentile of Nephrology 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 | $968.54 | $297.09 | 3.26x | $671.45 | $1.1M | 7.8K | 3.8K |
| 2015 | $837.56 | $252.85 | 3.31x | $584.71 | $1.2M | 8.8K | 4.0K |
| 2016 | $718.88 | $210.73 | 3.41x | $508.15 | $1.1M | 8.4K | 4.2K |
| 2017 | $934.43 | $299.77 | 3.12x | $634.66 | $1.1M | 8.4K | 3.9K |
| 2018 | $602.95 | $196.48 | 3.07x | $406.47 | $761.9K | 7.5K | 3.6K |
| 2019 | $327.67 | $109.54 | 2.99x | $218.13 | $745.1K | 7.7K | 3.5K |
| 2020 | $352.30 | $117.64 | 2.99x | $234.66 | $708.6K | 6.8K | 2.9K |
| 2021 | $323.91 | $119.72 | 2.71x | $204.19 | $612.5K | 5.6K | 2.4K |
| 2022 | $340.76 | $123.12 | 2.77x | $217.64 | $477.7K | 4.5K | 2.0K |
| 2023 | $361.74 | $131.60 | 2.75x | $230.14 | $451.4K | 4.3K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 5.5K | $1.3M | $240.69 | 2.41x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 19.0K | $1.1M | $57.86 | 3.02x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 11.7K | $990.4K | $84.42 | 2.67x |
| 35476 | Balloon dilation of narrowed or blocked vein, accessed through the skin | 734 | $730.8K | $995.60 | 3.60x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.8K | $613.6K | $159.76 | 2.50x |
| 90935 | Hemodialysis procedure with one physician evaluation | 8.0K | $464.4K | $58.32 | 3.77x |
| 36902 | Insertion of needle and/or catheter into dialysis circuit and balloon dilation of dialysis segment, with imaging including radiological supervision and interpretation | 1.2K | $442.4K | $355.08 | 3.22x |
| 36147 | Insertion of needle and/or catheter for dialysis | 1.0K | $341.9K | $340.87 | 5.73x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.8K | $300.9K | $79.19 | 2.53x |
| 35475 | Balloon dilation of narrowed or blocked upper arm artery, accessed through the skin | 175 | $203.1K | $1.2K | 3.60x |
| 36903 | Insertion of needle and/or catheter into dialysis circuit and insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation | 111 | $183.8K | $1.7K | 3.21x |
| 36870 | Catheter removal of blood clot from dialysis graft, accessed through the skin | 142 | $182.2K | $1.3K | 3.45x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 884 | $170.9K | $193.35 | 2.49x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.8K | $152.2K | $85.29 | 2.34x |
| 36905 | Excision of blood clot and/or infusion to dissolve blood clot in dialysis circuit and balloon dilation of dialysis segment, , accessed through the skin, with imaging including radiological supervision and interpretation | 173 | $125.6K | $725.99 | 3.24x |
| 37238 | Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation | 34 | $108.1K | $3.2K | 2.89x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 818 | $88.2K | $107.78 | 2.78x |
| 75978 | Radiological supervision and interpretation of balloon dilation of narrowed vein | 733 | $77.7K | $105.94 | 3.54x |
| 36907 | Balloon dilation of dialysis segment, accessed through the skin, with imaging including radiological supervision and interpretation | 339 | $75.5K | $222.67 | 3.15x |
| 36148 | Insertion of needle and/or catheter into an artery-vein dialysis shunt or graft | 336 | $68.0K | $202.49 | 3.07x |
This provider submits charges 3.05 times higher than what Medicare actually pays.
A markup ratio of 3.05x means for every $100 Medicare pays, this provider initially charges $305. 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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