This provider's $4.7M in total Medicare payments ranks in the 99th percentile of General Surgery 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 |
|---|---|---|---|---|---|---|---|
| 2017 | $190.59 | $135.58 | 1.41x | $55.01 | $521.4K | 3.3K | 991 |
| 2018 | $251.39 | $138.39 | 1.82x | $113.00 | $564.3K | 4.3K | 1.0K |
| 2019 | $278.79 | $153.47 | 1.82x | $125.32 | $762.9K | 6.1K | 1.0K |
| 2020 | $255.45 | $140.59 | 1.82x | $114.86 | $858.2K | 6.9K | 1.2K |
| 2021 | $269.31 | $131.46 | 2.05x | $137.85 | $724.6K | 5.9K | 1.2K |
| 2022 | $274.83 | $127.43 | 2.16x | $147.40 | $685.3K | 5.2K | 1.1K |
| 2023 | $300.86 | $106.83 | 2.82x | $194.03 | $630.8K | 5.3K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 12.4K | $2.4M | $194.09 | 1.82x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 14.4K | $1.4M | $99.93 | 1.92x |
| 49450 | Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin | 475 | $278.7K | $586.72 | 1.65x |
| 11046 | Removal of skin and/or muscle | 3.8K | $234.8K | $62.03 | 2.30x |
| 11045 | Removal of skin and tissue | 2.2K | $78.2K | $35.35 | 3.40x |
| 97610 | Therapy procedure using ultrasound | 206 | $77.5K | $376.41 | 2.53x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.1K | $63.3K | $60.31 | 2.18x |
| 17250 | Application of chemical agent to excessive wound tissue | 670 | $37.4K | $55.82 | 2.69x |
| 99348 | Established patient home visit, typically 25 minutes | 475 | $31.1K | $65.46 | 2.41x |
| 99343 | New patient home visit, typically 45 minutes | 274 | $28.5K | $104.13 | 1.66x |
| 93922 | Ultrasound study of arteries of both arms and legs | 307 | $23.9K | $78.00 | 1.90x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 140 | $14.9K | $106.52 | 2.44x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 183 | $6.4K | $34.76 | 3.80x |
| 99347 | Established patient home visit, typically 15 minutes | 100 | $4.3K | $43.32 | 2.11x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 29 | $4.0K | $136.55 | 2.75x |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 63 | $3.7K | $59.47 | 3.71x |
| 99304 | Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 49 | $3.3K | $68.00 | 3.16x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 18 | $1.6K | $90.56 | 2.41x |
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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