This provider's $3.8M in total Medicare payments ranks in the 99th percentile of General Surgery providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 64% in 2023
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 | $205.67 | $97.98 | 2.10x | $107.69 | $572.7K | 5.7K | 2.1K |
| 2015 | $222.40 | $85.09 | 2.61x | $137.31 | $375.5K | 5.2K | 1.5K |
| 2016 | $243.45 | $93.00 | 2.62x | $150.45 | $443.5K | 4.7K | 1.8K |
| 2017 | $274.16 | $105.07 | 2.61x | $169.09 | $469.0K | 4.5K | 2.0K |
| 2018 | $259.31 | $89.66 | 2.89x | $169.65 | $362.1K | 4.5K | 2.3K |
| 2019 | $292.07 | $87.34 | 3.34x | $204.73 | $431.3K | 5.7K | 2.3K |
| 2020 | $260.27 | $91.39 | 2.85x | $168.88 | $346.0K | 4.6K | 2.0K |
| 2021 | $255.07 | $106.15 | 2.40x | $148.92 | $322.0K | 3.8K | 1.7K |
| 2022 | $316.76 | $105.37 | 3.01x | $211.39 | $167.4K | 1.9K | 890 |
| 2023 | $328.57 | $140.77 | 2.33x | $187.80 | $274.3K | 1.9K | 900 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 11.2K | $869.3K | $77.96 | 2.65x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 12.8K | $756.4K | $58.98 | 2.91x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 2.6K | $461.8K | $178.17 | 2.48x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 5.3K | $411.7K | $77.24 | 3.01x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.4K | $335.7K | $142.50 | 2.61x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.7K | $187.1K | $108.33 | 2.78x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 756 | $186.1K | $246.12 | 2.18x |
| 97610 | Therapy procedure using ultrasound | 263 | $112.5K | $427.94 | 1.52x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 937 | $107.9K | $115.20 | 2.17x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.3K | $48.1K | $36.20 | 3.36x |
| Q4169 | Artacent wound, per square centimeter | 135 | $46.0K | $340.56 | 1.79x |
| 17250 | Application of chemical agent to excessive wound tissue | 664 | $43.6K | $65.65 | 3.07x |
| 15271 | Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) | 243 | $34.9K | $143.82 | 1.81x |
| 11046 | Removal of skin and/or muscle | 606 | $34.7K | $57.29 | 2.61x |
| 11045 | Removal of skin and tissue | 865 | $24.9K | $28.76 | 2.88x |
| Q4210 | Axolotl graft or axolotl dualgraft, per square centimeter | 35 | $22.8K | $651.68 | 1.34x |
| 11047 | Removal of skin and bone | 213 | $21.5K | $101.06 | 2.08x |
| Q4173 | Palingen or palingen xplus, per square centimeter | 47 | $18.0K | $382.74 | 1.28x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 184 | $14.0K | $76.24 | 2.55x |
| 0598T | Fluorescence wound imaging for bacteria, first anatomic site | 90 | $13.4K | $149.31 | 6.09x |
This provider submits charges 2.64 times higher than what Medicare actually pays.
A markup ratio of 2.64x means for every $100 Medicare pays, this provider initially charges $264. 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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