This provider's $7.8M in total Medicare payments ranks in the 96th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.27x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 166% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 87% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $1.3K | $220.64 | 5.98x | $1.1K | $1.4M | 6.4K | 18 |
| 2022 | $1.6K | $290.75 | 5.35x | $1.3K | $2.6M | 9.0K | 25 |
| 2023 | $2.0K | $400.36 | 4.94x | $1.6K | $3.7M | 9.3K | 28 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 281 | $1.5M | $5.3K | 3.57x |
| 52356 | Crushing of stone of ureter with insertion of stent using an endoscope | 846 | $1.3M | $1.5K | 6.58x |
| 55700 | Biopsy of prostate gland | 1.1K | $650.0K | $606.30 | 5.45x |
| 54405 | Insertion of multicomponent inflatable penile implant | 41 | $489.2K | $11.9K | 3.22x |
| 52648 | Complete laser vaporization of prostate including control of bleeding using an endoscope | 296 | $472.9K | $1.6K | 9.30x |
| 64590 | Insertion of peripheral or gastric neurostimulator generator | 31 | $428.4K | $13.8K | 3.22x |
| 52332 | Insertion of stent in ureter using an endoscope | 509 | $418.4K | $822.02 | 7.82x |
| 63685 | Insertion of spinal neurostimulator generator or receiver | 19 | $333.7K | $17.6K | 3.36x |
| 64561 | Insertion of sacral nerve neurostimulator electrode array | 58 | $212.5K | $3.7K | 4.01x |
| 63655 | Removal of spine bone for insertion of neurostimulator electrode plate in spine | 15 | $200.4K | $13.4K | 3.09x |
| 52234 | Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm | 181 | $183.1K | $1.0K | 5.64x |
| 74420 | Imaging of urinary tract following injection of a contrast agent | 952 | $135.5K | $142.38 | 4.78x |
| 52351 | Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope | 130 | $130.9K | $1.0K | 5.66x |
| 55874 | Injection of biodegradable material next to prostate | 50 | $127.8K | $2.6K | 2.84x |
| 52235 | Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm | 122 | $123.0K | $1.0K | 5.66x |
| 63030 | Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc | 50 | $103.5K | $2.1K | 5.57x |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 18.7K | $92.0K | $4.92 | 1.84x |
| 52287 | Exam with injections of chemical for destruction of bladder using an endoscope | 146 | $83.7K | $573.20 | 9.37x |
| 52204 | Biopsy of bladder using an endoscope | 129 | $71.3K | $552.34 | 9.72x |
| 52352 | Removal or manipulation of stone in ureter or kidney using an endoscope | 70 | $69.9K | $997.87 | 5.72x |
This provider submits charges 5.27 times higher than what Medicare actually pays.
A markup ratio of 5.27x means for every $100 Medicare pays, this provider initially charges $527. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Roanoke Valley Center For Sight Llc | Salem, VA | $57.7M | ✓ Clear |
| Stony Point Surgery Center, L.L.C | Richmond, VA | $45.5M | ✓ Clear |
| Virginia Eye Institute Inc | Richmond, VA | $40.0M | ✓ Clear |
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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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