This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
Medicare payments to this provider grew 249% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 256% in 2018
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 | $160.71 | $67.24 | 2.39x | $93.47 | $174.3K | 1.9K | 570 |
| 2015 | $160.83 | $68.74 | 2.34x | $92.09 | $162.0K | 1.9K | 556 |
| 2016 | $160.83 | $69.18 | 2.32x | $91.65 | $66.9K | 754 | 237 |
| 2017 | $183.00 | $75.91 | 2.41x | $107.09 | $59.1K | 585 | 129 |
| 2018 | $161.67 | $68.85 | 2.35x | $92.82 | $210.2K | 2.0K | 574 |
| 2019 | $190.00 | $82.37 | 2.31x | $107.63 | $606.5K | 6.6K | 1.6K |
| 2020 | $190.68 | $85.94 | 2.22x | $104.74 | $859.7K | 9.7K | 1.8K |
| 2021 | $204.99 | $97.05 | 2.11x | $107.94 | $825.7K | 9.0K | 1.8K |
| 2022 | $190.75 | $87.56 | 2.18x | $103.19 | $713.8K | 8.0K | 1.8K |
| 2023 | $237.56 | $67.17 | 3.54x | $170.39 | $608.8K | 7.1K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 11.7K | $2.0M | $172.95 | 2.09x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 14.6K | $749.9K | $51.45 | 2.92x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 7.6K | $660.1K | $87.33 | 2.29x |
| 17250 | Application of chemical agent to excessive wound tissue | 5.8K | $371.6K | $64.01 | 2.34x |
| 11046 | Removal of skin and/or muscle | 3.9K | $206.7K | $53.53 | 2.26x |
| 43762 | Replacement of stomach stoma tube accessed through skin | 918 | $172.0K | $187.33 | 2.14x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.8K | $56.9K | $31.87 | 2.67x |
| 11045 | Removal of skin and tissue | 1.2K | $34.8K | $30.11 | 1.79x |
| 97597 | Removal of tissue from wounds per session | 158 | $9.1K | $57.33 | 2.79x |
| 49450 | Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast | 14 | $659.28 | $47.09 | 21.24x |
This provider submits charges 2.31 times higher than what Medicare actually pays.
A markup ratio of 2.31x means for every $100 Medicare pays, this provider initially charges $231. 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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