This provider averages 75 services per working day
Based on 187.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $9.2M in total Medicare payments ranks in the 99th percentile of Urology providers nationally.
Averaging 75 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 64% from 2014 to 2023.
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 | $573.10 | $105.28 | 5.44x | $467.82 | $697.8K | 11.5K | 7.2K |
| 2015 | $646.88 | $124.42 | 5.20x | $522.46 | $836.6K | 14.8K | 9.3K |
| 2016 | $769.58 | $140.82 | 5.46x | $628.76 | $892.0K | 15.3K | 9.8K |
| 2017 | $679.18 | $128.18 | 5.30x | $551.00 | $992.2K | 18.8K | 11.9K |
| 2018 | $659.96 | $118.38 | 5.57x | $541.58 | $788.8K | 17.0K | 10.8K |
| 2019 | $757.18 | $115.31 | 6.57x | $641.87 | $808.2K | 16.6K | 10.5K |
| 2020 | $774.80 | $115.03 | 6.74x | $659.77 | $751.3K | 16.3K | 11.1K |
| 2021 | $762.81 | $137.63 | 5.54x | $625.18 | $1.1M | 24.1K | 16.8K |
| 2022 | $670.37 | $97.25 | 6.89x | $573.12 | $1.2M | 27.4K | 19.1K |
| 2023 | $747.35 | $116.51 | 6.41x | $630.84 | $1.1M | 25.6K | 17.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.5K | $1.1M | $91.38 | 3.78x |
| 51728 | Insertion of electronic device into bladder with voiding pressure studies | 2.7K | $855.2K | $318.28 | 2.26x |
| 76856 | Ultrasound of pelvis | 7.5K | $695.9K | $92.51 | 4.50x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.9K | $491.9K | $62.24 | 3.23x |
| 55866 | Surgical removal of prostate and surrounding lymph nodes using an endoscope | 376 | $428.9K | $1.1K | 7.77x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 1.2K | $316.2K | $254.21 | 4.66x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $271.0K | $128.14 | 3.27x |
| 76770 | Ultrasound behind abdominal cavity | 2.5K | $249.6K | $101.36 | 4.06x |
| 84403 | Testosterone (hormone) level | 8.5K | $247.0K | $29.11 | 3.26x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.1K | $185.4K | $166.75 | 2.90x |
| 82306 | Vitamin D-3 level | 5.5K | $179.5K | $32.88 | 3.04x |
| 84153 | PSA (prostate specific antigen) measurement | 8.6K | $179.5K | $20.75 | 3.37x |
| 74178 | CT scan of abdomen and pelvis before and after contrast | 674 | $159.5K | $236.65 | 5.52x |
| 88121 | Cell examination of urine | 349 | $157.0K | $449.71 | 3.34x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $125.7K | $114.56 | 3.11x |
| 82670 | Estradiol (hormone) level | 3.6K | $107.8K | $30.11 | 2.99x |
| 64566 | Implantation of lower leg neurostimulator electrode, accessed through the skin | 943 | $105.6K | $111.95 | 4.54x |
| 50543 | Partial removal of kidney using an endoscope | 88 | $100.8K | $1.1K | 5.75x |
| 51729 | Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies | 311 | $99.0K | $318.33 | 2.14x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 577 | $93.6K | $162.16 | 3.85x |
This provider submits charges 4.42 times higher than what Medicare actually pays.
A markup ratio of 4.42x means for every $100 Medicare pays, this provider initially charges $442. 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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