This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation providers nationally.
Their average markup ratio of 5.17x is significantly above the specialty median of 3.7x.
Medicare payments to this provider grew 2234% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 180% in 2016
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 | $311.48 | $62.53 | 4.98x | $248.95 | $47.7K | 811 | 266 |
| 2015 | $309.56 | $71.38 | 4.34x | $238.18 | $64.7K | 918 | 296 |
| 2016 | $362.26 | $85.50 | 4.24x | $276.76 | $180.8K | 2.1K | 915 |
| 2017 | $456.81 | $103.82 | 4.40x | $352.99 | $116.3K | 1.3K | 596 |
| 2018 | $398.28 | $114.26 | 3.49x | $284.02 | $265.2K | 2.5K | 1.2K |
| 2019 | $372.26 | $104.59 | 3.56x | $267.67 | $618.8K | 6.6K | 2.2K |
| 2020 | $287.51 | $93.80 | 3.07x | $193.71 | $690.6K | 7.5K | 2.2K |
| 2021 | $495.65 | $65.07 | 7.62x | $430.58 | $848.0K | 9.0K | 2.9K |
| 2022 | $772.34 | $78.14 | 9.88x | $694.20 | $996.3K | 10.6K | 4.2K |
| 2023 | $1.3K | $96.12 | 13.56x | $1.2K | $1.1M | 10.6K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 10.9K | $1.7M | $153.77 | 3.25x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 17.5K | $1.7M | $95.99 | 5.59x |
| 80307 | Testing for presence of drug | 11.7K | $724.5K | $62.05 | 7.24x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.1K | $189.4K | $61.50 | 4.79x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $163.5K | $133.90 | 5.50x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 355 | $64.1K | $180.68 | 6.74x |
| 95923 | Testing of autonomic (sympathetic) nervous system function | 519 | $57.6K | $110.92 | 7.26x |
| 96132 | Neuropsychological testing evaluation by qualified health care professional, first 60 minutes | 533 | $56.3K | $105.61 | 10.49x |
| 95921 | Testing of autonomic (sympathetic) nervous system function | 523 | $40.3K | $76.99 | 6.85x |
| 93922 | Ultrasound study of arteries of both arms and legs | 530 | $38.0K | $71.62 | 7.30x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 805 | $31.3K | $38.88 | 4.46x |
| 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 | 314 | $24.1K | $76.70 | 3.86x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 363 | $21.9K | $60.40 | 23.03x |
| 96138 | Psychological or neuropsychological test administration and scoring by technician, first 30 minutes | 653 | $19.9K | $30.44 | 10.96x |
| G0482 | 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 | 97 | $19.0K | $196.01 | 2.54x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 111 | $16.7K | $150.43 | 5.65x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 351 | $15.1K | $43.07 | 1.83x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 278 | $14.8K | $53.38 | 1.94x |
| 99452 | Telephone or internet referral service, 30 minutes | 468 | $14.5K | $31.02 | 4.84x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 34 | $7.3K | $213.29 | 6.11x |
This provider submits charges 5.17 times higher than what Medicare actually pays.
A markup ratio of 5.17x means for every $100 Medicare pays, this provider initially charges $517. 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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