This provider's $7.9M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 213% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 144% in 2018
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 | $191.38 | $52.26 | 3.66x | $139.12 | $625.9K | 6.1K | 5.4K |
| 2015 | $309.82 | $93.83 | 3.30x | $215.99 | $331.6K | 1.3K | 1.2K |
| 2016 | $444.09 | $150.74 | 2.95x | $293.35 | $313.4K | 4.5K | 4.1K |
| 2017 | $599.09 | $205.74 | 2.91x | $393.35 | $248.1K | 3.4K | 3.3K |
| 2018 | $614.35 | $211.08 | 2.91x | $403.27 | $604.8K | 7.2K | 6.8K |
| 2019 | $692.92 | $186.07 | 3.72x | $506.85 | $773.0K | 9.1K | 8.4K |
| 2020 | $688.36 | $192.17 | 3.58x | $496.19 | $677.3K | 8.1K | 7.0K |
| 2021 | $741.50 | $211.82 | 3.50x | $529.68 | $1.0M | 12.1K | 10.9K |
| 2022 | $729.81 | $244.71 | 2.98x | $485.10 | $1.3M | 10.9K | 8.7K |
| 2023 | $763.94 | $243.37 | 3.14x | $520.57 | $2.0M | 8.5K | 7.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88120 | Cell examination of urine | 4.4K | $2.0M | $460.68 | 3.46x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 881 | $1.6M | $1.8K | 2.82x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 14.4K | $501.8K | $34.74 | 7.65x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 2.1K | $498.8K | $234.31 | 4.01x |
| 81455 | Test for detecting genes associated with cancer | 126 | $360.7K | $2.9K | 2.23x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 4.3K | $350.6K | $81.32 | 1.55x |
| 88108 | Cell examination of specimen | 8.1K | $343.8K | $42.61 | 5.95x |
| 88342 | Tissue or cell analysis by immunologic technique | 6.1K | $333.3K | $54.78 | 5.86x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 5.4K | $291.4K | $53.69 | 4.34x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 6.8K | $259.8K | $38.16 | 5.21x |
| 88344 | Special stained specimen slides to examine tissue | 1.6K | $216.8K | $135.16 | 3.24x |
| 88377 | Microscopic genetic examination manual | 624 | $179.0K | $286.91 | 2.60x |
| 87507 | Detection test for digestive tract pathogen | 287 | $133.9K | $466.44 | 2.77x |
| 87426 | Elisa detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 3.7K | $131.1K | $35.17 | 2.84x |
| 86328 | Test for detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody, qualitative or semiquantitative | 2.5K | $113.1K | $44.97 | 2.22x |
| 88341 | Special stained specimen slides to examine tissue | 1.6K | $89.6K | $55.00 | 5.92x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 35 | $78.8K | $2.3K | 1.60x |
| 88112 | Cell examination of specimen | 2.0K | $67.9K | $33.82 | 9.95x |
| 88381 | Preparation of specimen, manual | 454 | $41.6K | $91.53 | 3.26x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 365 | $28.9K | $79.27 | 4.26x |
This provider submits charges 3.8 times higher than what Medicare actually pays.
A markup ratio of 3.8x means for every $100 Medicare pays, this provider initially charges $380. 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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