This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
63% of their billing comes from a single procedure code (Q4205 — Membrane graft or membrane wrap, per square centimeter).
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 |
|---|---|---|---|---|---|---|---|
| 2023 | $1.2K | $952.23 | 1.31x | $293.59 | $3.8M | 4.0K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 2.2K | $2.4M | $1.1K | 1.29x |
| Q4221 | Amniowrap2, per square centimeter | 692 | $685.7K | $990.90 | 1.28x |
| Q4204 | Xwrap, per square centimeter | 420 | $453.4K | $1.1K | 1.30x |
| Q4250 | Amnioamp-mp, per square centimeter | 184 | $238.0K | $1.3K | 1.28x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 250 | $13.5K | $54.09 | 3.68x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 84 | $9.6K | $113.95 | 3.29x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 54 | $9.3K | $172.75 | 3.26x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 61 | $6.0K | $98.85 | 3.17x |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 42 | $2.3K | $54.13 | 3.44x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 19 | $1.7K | $91.22 | 3.39x |
This provider submits charges 1.31 times higher than what Medicare actually pays.
A markup ratio of 1.31x means for every $100 Medicare pays, this provider initially charges $131. This is lower 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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