This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Pain Management 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 94% in 2019
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 | $396.40 | $95.06 | 4.17x | $301.34 | $305.7K | 3.7K | 1.7K |
| 2015 | $318.69 | $90.51 | 3.52x | $228.18 | $524.4K | 6.3K | 2.8K |
| 2016 | $388.93 | $93.84 | 4.14x | $295.09 | $954.2K | 9.5K | 4.6K |
| 2017 | $389.72 | $85.50 | 4.56x | $304.22 | $1.0M | 10.8K | 4.9K |
| 2018 | $378.81 | $113.45 | 3.34x | $265.36 | $297.6K | 3.1K | 1.8K |
| 2019 | $901.49 | $486.82 | 1.85x | $414.67 | $577.2K | 4.1K | 2.3K |
| 2020 | $368.21 | $122.02 | 3.02x | $246.19 | $343.2K | 3.3K | 2.2K |
| 2021 | $499.32 | $189.33 | 2.64x | $309.99 | $417.5K | 3.3K | 2.4K |
| 2022 | $567.46 | $211.47 | 2.68x | $355.99 | $411.8K | 3.5K | 2.5K |
| 2023 | $565.29 | $210.22 | 2.69x | $355.07 | $429.6K | 3.3K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.9K | $1.2M | $89.74 | 2.75x |
| G0483 | Drug test def 22+ classes | 2.2K | $496.2K | $225.95 | 1.73x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 2.4K | $396.0K | $165.96 | 3.03x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 769 | $356.3K | $463.35 | 2.34x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 1.5K | $270.9K | $181.23 | 3.33x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.0K | $192.4K | $64.73 | 2.49x |
| 62369 | Electronic analysis reprogramming and refill of spinal canal drug infusion pump | 1.5K | $162.6K | $110.45 | 1.81x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 230 | $159.1K | $691.80 | 4.56x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $155.8K | $135.84 | 2.78x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 1.4K | $131.4K | $95.25 | 2.71x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 677 | $123.5K | $182.43 | 3.01x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 643 | $112.7K | $175.20 | 3.88x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 568 | $103.3K | $181.80 | 3.09x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 1.2K | $95.9K | $77.37 | 1.62x |
| J3490 | Unclassified drugs | 586 | $94.8K | $161.72 | 1.54x |
| 22513 | Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance | 13 | $89.1K | $6.9K | 1.34x |
| 22514 | Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance | 12 | $82.1K | $6.8K | 1.35x |
| 76881 | Ultrasound of leg or arm | 682 | $74.4K | $109.13 | 1.60x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 870 | $74.0K | $85.02 | 2.72x |
| 80307 | Testing for presence of drug | 926 | $72.1K | $77.83 | 1.61x |
This provider submits charges 2.69 times higher than what Medicare actually pays.
A markup ratio of 2.69x means for every $100 Medicare pays, this provider initially charges $269. 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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