This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Sports Medicine providers nationally.
Medicare payments to this provider grew 98% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 67% in 2015
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 | $149.77 | $52.51 | 2.85x | $97.26 | $210.4K | 3.3K | 1.4K |
| 2015 | $190.20 | $69.05 | 2.75x | $121.15 | $350.8K | 4.9K | 1.8K |
| 2016 | $123.20 | $43.56 | 2.83x | $79.64 | $341.4K | 5.2K | 2.0K |
| 2017 | $137.81 | $47.43 | 2.91x | $90.38 | $306.9K | 4.5K | 1.7K |
| 2018 | $161.54 | $60.43 | 2.67x | $101.11 | $375.8K | 5.3K | 1.9K |
| 2019 | $127.26 | $45.75 | 2.78x | $81.51 | $278.9K | 4.1K | 1.5K |
| 2020 | $128.21 | $45.07 | 2.84x | $83.14 | $238.0K | 3.5K | 1.3K |
| 2021 | $316.17 | $123.93 | 2.55x | $192.24 | $344.7K | 4.3K | 1.6K |
| 2022 | $137.18 | $49.65 | 2.76x | $87.53 | $436.4K | 5.9K | 2.3K |
| 2023 | $147.36 | $53.10 | 2.78x | $94.26 | $416.0K | 5.7K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.8K | $1.1M | $89.49 | 2.63x |
| 98929 | Osteopathic manipulative treatment to 9-10 body regions | 13.9K | $953.1K | $68.43 | 2.74x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.1K | $384.9K | $123.02 | 2.56x |
| 98928 | Osteopathic manipulative treatment to 7-8 body regions | 3.2K | $189.6K | $59.14 | 2.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $135.0K | $121.47 | 2.90x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.9K | $89.1K | $48.05 | 2.77x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.4K | $81.6K | $59.47 | 2.57x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.3K | $64.7K | $49.85 | 3.74x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 633 | $40.4K | $63.89 | 2.82x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 360 | $29.2K | $81.17 | 2.84x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 538 | $26.0K | $48.28 | 2.59x |
| Q4206 | Fluid flow or fluid gf, 1 cc | 15 | $24.7K | $1.6K | 2.57x |
| 20553 | Injections of trigger points in 3 or more muscles | 476 | $24.2K | $50.83 | 2.61x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 89 | $12.5K | $140.97 | 2.70x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 414 | $11.3K | $27.41 | 2.77x |
| 62323 | Injection of substance into lower spine canal using imaging guidance | 46 | $9.7K | $211.86 | 2.58x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 1.9K | $9.1K | $4.71 | 6.35x |
| 64445 | Injection of anesthetic agent, sciatic nerve | 77 | $8.8K | $114.33 | 2.49x |
| J0897 | Injection, denosumab, 1 mg | 484 | $7.4K | $15.36 | 2.17x |
| 73560 | X-ray of knee, 1 or 2 views | 249 | $6.0K | $24.24 | 2.68x |
This provider submits charges 2.71 times higher than what Medicare actually pays.
A markup ratio of 2.71x means for every $100 Medicare pays, this provider initially charges $271. 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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