This provider's $6.9M 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.
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 | $383.12 | $101.27 | 3.78x | $281.85 | $693.5K | 10.1K | 5.6K |
| 2015 | $348.72 | $94.63 | 3.69x | $254.09 | $887.7K | 12.4K | 7.2K |
| 2016 | $385.20 | $100.13 | 3.85x | $285.07 | $686.7K | 9.6K | 5.2K |
| 2017 | $374.23 | $123.12 | 3.04x | $251.11 | $778.9K | 8.2K | 3.8K |
| 2018 | $407.79 | $101.25 | 4.03x | $306.54 | $500.1K | 7.1K | 3.5K |
| 2019 | $544.84 | $115.61 | 4.71x | $429.23 | $622.3K | 7.4K | 3.0K |
| 2020 | $499.99 | $127.31 | 3.93x | $372.68 | $589.4K | 7.1K | 2.8K |
| 2021 | $536.68 | $144.25 | 3.72x | $392.43 | $617.0K | 6.0K | 3.3K |
| 2022 | $723.03 | $196.32 | 3.68x | $526.71 | $728.8K | 7.1K | 3.3K |
| 2023 | $684.09 | $175.62 | 3.90x | $508.47 | $787.0K | 7.6K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 4.8K | $876.0K | $181.74 | 4.76x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 3.8K | $822.4K | $213.79 | 4.27x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 1.3K | $583.8K | $440.26 | 3.50x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 2.6K | $484.9K | $189.85 | 4.79x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 4.8K | $462.7K | $96.56 | 4.48x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 3.8K | $365.8K | $95.83 | 4.61x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.7K | $330.7K | $49.34 | 3.08x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 1.3K | $284.9K | $215.20 | 2.81x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 1.4K | $256.1K | $182.41 | 3.24x |
| 64491 | Injections of upper or middle spine facet joint using imaging guidance | 2.5K | $251.4K | $99.36 | 4.58x |
| 64492 | Injections of upper or middle spine facet joint using imaging guidance | 2.1K | $208.4K | $98.73 | 4.65x |
| 80307 | Testing for presence of drug | 2.9K | $192.3K | $65.71 | 4.35x |
| 62311 | Injections of substances into lower or sacral spine | 1.3K | $192.1K | $144.22 | 3.67x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 347 | $158.6K | $457.10 | 3.73x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 1.6K | $154.1K | $96.79 | 1.34x |
| G0480 | Drug test def 1-7 classes | 1.0K | $114.6K | $111.79 | 2.69x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 794 | $108.8K | $137.01 | 4.93x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 2.2K | $100.7K | $46.68 | 2.14x |
| 64634 | Destruction of upper or middle spinal facet joint nerves with imaging guidance | 346 | $86.2K | $249.24 | 2.99x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.1K | $79.8K | $75.88 | 2.50x |
This provider submits charges 3.94 times higher than what Medicare actually pays.
A markup ratio of 3.94x means for every $100 Medicare pays, this provider initially charges $394. 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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