This provider's $4.0M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $575.21 | $93.81 | 6.13x | $481.40 | $319.7K | 7.0K | 4.4K |
| 2015 | $462.99 | $77.71 | 5.96x | $385.28 | $340.1K | 7.0K | 4.6K |
| 2016 | $386.72 | $85.67 | 4.51x | $301.05 | $384.6K | 7.7K | 4.8K |
| 2017 | $398.43 | $78.92 | 5.05x | $319.51 | $350.7K | 7.4K | 4.6K |
| 2018 | $598.50 | $110.43 | 5.42x | $488.07 | $380.7K | 7.5K | 4.8K |
| 2019 | $589.82 | $115.14 | 5.12x | $474.68 | $463.1K | 8.0K | 5.3K |
| 2020 | $379.30 | $86.64 | 4.38x | $292.66 | $392.0K | 6.0K | 4.6K |
| 2021 | $367.44 | $97.96 | 3.75x | $269.48 | $455.6K | 6.6K | 4.9K |
| 2022 | $323.23 | $104.24 | 3.10x | $218.99 | $465.0K | 6.9K | 5.2K |
| 2023 | $299.15 | $97.82 | 3.06x | $201.33 | $440.1K | 7.0K | 5.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 20.6K | $1.3M | $64.87 | 2.31x |
| 76770 | Ultrasound behind abdominal cavity | 7.1K | $745.4K | $104.47 | 2.95x |
| 76856 | Ultrasound of pelvis | 7.9K | $507.1K | $64.52 | 4.77x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 1.5K | $274.6K | $186.18 | 3.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $237.8K | $140.16 | 2.50x |
| 76872 | Ultrasound of rectum | 1.9K | $211.8K | $110.72 | 5.02x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 928 | $86.0K | $92.66 | 3.24x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 473 | $78.4K | $165.86 | 4.82x |
| 81002 | Urinalysis, manual test | 20.8K | $71.0K | $3.41 | 7.32x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 230 | $63.9K | $277.99 | 5.00x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 654 | $51.2K | $78.26 | 2.56x |
| 76775 | Ultrasound behind abdominal cavity, limited | 640 | $37.4K | $58.42 | 4.28x |
| 76857 | Ultrasound of pelvis | 731 | $33.6K | $45.95 | 5.44x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 659 | $33.1K | $50.27 | 1.99x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 51 | $33.0K | $647.05 | 6.18x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 2.1K | $32.4K | $15.21 | 9.86x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 774 | $30.8K | $39.80 | 2.51x |
| 51700 | Bladder irrigation and/or instillation | 352 | $25.5K | $72.38 | 4.14x |
| 51720 | Bladder instillation of cancer preventive, inhibiting, or suppressive agent | 204 | $16.2K | $79.60 | 5.03x |
| 96402 | Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle | 502 | $15.1K | $30.12 | 4.98x |
This provider submits charges 3.48 times higher than what Medicare actually pays.
A markup ratio of 3.48x means for every $100 Medicare pays, this provider initially charges $348. 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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