This provider's $7.3M 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.
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 | $361.38 | $107.80 | 3.35x | $253.58 | $662.6K | 9.8K | 5.4K |
| 2015 | $450.33 | $106.78 | 4.22x | $343.55 | $615.7K | 9.3K | 5.0K |
| 2016 | $467.81 | $113.54 | 4.12x | $354.27 | $604.4K | 8.5K | 5.5K |
| 2017 | $503.99 | $118.42 | 4.26x | $385.57 | $656.3K | 8.4K | 5.6K |
| 2018 | $520.22 | $123.23 | 4.22x | $396.99 | $817.7K | 9.6K | 6.3K |
| 2019 | $545.32 | $137.70 | 3.96x | $407.62 | $841.8K | 9.1K | 5.9K |
| 2020 | $533.24 | $136.26 | 3.91x | $396.98 | $846.0K | 8.7K | 5.7K |
| 2021 | $546.98 | $145.13 | 3.77x | $401.85 | $900.8K | 8.3K | 5.4K |
| 2022 | $572.74 | $145.46 | 3.94x | $427.28 | $759.9K | 6.9K | 5.1K |
| 2023 | $566.56 | $151.24 | 3.75x | $415.32 | $564.7K | 5.7K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 16.7K | $910.5K | $54.53 | 2.93x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 3.4K | $908.6K | $263.97 | 3.58x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 4.0K | $780.4K | $196.71 | 3.51x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.6K | $557.5K | $120.23 | 2.86x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 903 | $440.9K | $488.24 | 3.69x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.5K | $438.1K | $79.66 | 2.75x |
| 64494 | Injections of lower or sacral spine facet joint using imaging guidance | 4.0K | $410.2K | $103.44 | 3.37x |
| 64484 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 3.4K | $398.7K | $117.36 | 3.62x |
| 64495 | Injections of lower or sacral spine facet joint using imaging guidance | 2.9K | $298.4K | $102.61 | 3.45x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 1.7K | $257.6K | $150.11 | 5.38x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 1.2K | $214.9K | $174.75 | 4.00x |
| 64479 | Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance | 681 | $201.2K | $295.50 | 3.64x |
| 64636 | Destruction of lower or sacral spinal facet joint nerves with imaging guidance | 903 | $199.3K | $220.73 | 3.63x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 746 | $164.0K | $219.81 | 3.61x |
| G0396 | Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | 4.7K | $131.3K | $27.78 | 2.41x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 15.2K | $129.0K | $8.48 | 2.04x |
| 64418 | Injection of anesthetic agent, collar bone nerve | 907 | $103.9K | $114.57 | 5.08x |
| 64480 | Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance | 681 | $101.9K | $149.67 | 3.46x |
| 62311 | Injections of substances into lower or sacral spine | 1.1K | $96.1K | $85.98 | 6.09x |
| 64491 | Injections of upper or middle spine facet joint using imaging guidance | 746 | $84.2K | $112.85 | 3.50x |
This provider submits charges 3.53 times higher than what Medicare actually pays.
A markup ratio of 3.53x means for every $100 Medicare pays, this provider initially charges $353. 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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