This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Pain Management providers nationally.
Their average markup ratio of 5.19x is significantly above the specialty median of 5.1x.
Medicare payments to this provider grew 7098% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 840% in 2017
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 | $305.00 | $100.50 | 3.03x | $204.50 | $18.4K | 197 | 165 |
| 2015 | $305.00 | $87.91 | 3.47x | $217.09 | $25.3K | 313 | 162 |
| 2016 | $430.00 | $127.57 | 3.37x | $302.43 | $15.2K | 123 | 114 |
| 2017 | $420.14 | $98.01 | 4.29x | $322.13 | $142.8K | 1.4K | 966 |
| 2018 | $583.28 | $100.24 | 5.82x | $483.04 | $665.2K | 6.2K | 4.1K |
| 2019 | $579.29 | $94.34 | 6.14x | $484.95 | $379.7K | 3.7K | 2.7K |
| 2020 | $554.91 | $85.40 | 6.50x | $469.51 | $292.8K | 3.9K | 2.7K |
| 2021 | $942.91 | $174.43 | 5.41x | $768.48 | $1.3M | 13.2K | 5.4K |
| 2022 | $892.79 | $166.79 | 5.35x | $726.00 | $1.7M | 17.0K | 5.7K |
| 2023 | $1.1K | $171.50 | 6.54x | $950.46 | $1.3M | 14.6K | 5.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (an | 4.9K | $1.2M | $243.79 | 4.47x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.6K | $730.5K | $62.74 | 5.58x |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 8.5K | $508.2K | $60.12 | 5.82x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 2.6K | $497.0K | $194.23 | 5.77x |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 2.0K | $400.5K | $195.77 | 4.89x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 1.1K | $353.6K | $335.17 | 5.59x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 1.1K | $219.4K | $191.98 | 4.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $186.6K | $112.70 | 4.15x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.3K | $171.4K | $75.59 | 4.97x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 1.1K | $170.6K | $161.69 | 5.44x |
| 62321 | Injection of substance into spinal canal of upper or middle back using imaging guidance | 718 | $143.3K | $199.55 | 5.79x |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 889 | $137.2K | $154.29 | 4.85x |
| 99152 | Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes | 3.3K | $128.3K | $38.99 | 4.57x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 1.1K | $114.2K | $101.69 | 5.69x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 251 | $88.2K | $351.26 | 5.55x |
| 80307 | Testing for presence of drug | 1.2K | $77.5K | $65.82 | 3.51x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 429 | $77.3K | $180.17 | 5.05x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 48 | $73.2K | $1.5K | 7.31x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 448 | $72.6K | $162.09 | 5.55x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 324 | $68.4K | $211.15 | 5.01x |
This provider submits charges 5.19 times higher than what Medicare actually pays.
A markup ratio of 5.19x means for every $100 Medicare pays, this provider initially charges $519. 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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