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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Carolina Mountain Gastroenterology Endoscopy Center
๐Ÿ”ช
Organization

Carolina Mountain Gastroenterology Endoscopy Center

NPI: 1093993727
Hendersonville, NC
10 years of data
Ambulatory Surgical Center
$8.5M
Total Payments
28.3K
Beneficiaries
28.8K
Services
3.08x
Markup Ratio

Peer Comparison

96th
percentile in specialty
This provider$8.5M
Specialty median$657.1K

๐Ÿ“‹ Key Findings

1Billed $8.5M over 10 years
23.08x markup ratio (above median)
396th percentile in Ambulatory Surgical Center by payments
46 procedures with >3x markup
โœ“ No flags detected

๐Ÿ”Ž Data Analysis

This provider's $8.5M in total Medicare payments ranks in the 96th percentile of Ambulatory Surgical Center providers nationally.

Medicare payments to this provider grew 57% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$766.17$262.602.92x$503.57$635.3K2.5K2.5K
2015$833.47$277.153.01x$556.32$707.1K2.5K2.5K
2016$793.83$295.232.69x$498.60$741.5K2.6K2.5K
2017$890.76$290.383.07x$600.38$820.9K2.9K2.9K
2018$856.80$295.002.90x$561.80$947.2K3.3K3.3K
2019$918.60$289.313.18x$629.29$949.2K3.2K3.2K
2020$976.22$355.502.75x$620.72$799.0K2.6K2.6K
2021$972.45$363.492.68x$608.96$991.3K3.1K3.1K
2022$985.00$360.432.73x$624.57$944.4K3.0K2.9K
2023$1.2K$391.783.02x$792.25$1.0M2.9K2.9K

Top Procedures (14)

45385Removal of polyps or growths of large bowel using an endoscope
$2.9M
8.6K services$344.38/svc2.73x markup
45380Biopsy of large bowel using an endoscopeโš  3.8x markup
$1.7M
6.7K services$253.52/svc3.75x markup
43239Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscopeโš  4.1x markup
$1.4M
7.1K services$201.17/svc4.11x markup
43249Balloon dilation of esophagus using an endoscope
$1.2M
2.6K services$462.66/svc2.09x markup
G0105Colorectal cancer screening; colonoscopy on individual at high risk
$465.5K
1.4K services$333.90/svc2.51x markup
G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
$280.1K
836 services$335.07/svc2.54x markup
45378Diagnostic examination of large bowel using an endoscopeโš  4.0x markup
$216.9K
880 services$246.48/svc3.95x markup
45390Removal of large bowel tissue using an endoscope
$165.9K
206 services$805.46/svc2.10x markup
44361Biopsy of small bowel using an endoscope
$32.2K
102 services$315.23/svc1.97x markup
43235Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscopeโš  3.6x markup
$30.7K
131 services$234.73/svc3.64x markup
45381Injections of large bowel using an endoscope
$21.7K
134 services$161.72/svc2.70x markup
45384Removal of polyps or growths in large bowel using an endoscopeโš  3.4x markup
$13.2K
51 services$259.40/svc3.37x markup
43245Dilation of stomach outlet using an endoscope
$10.9K
28 services$388.16/svc2.42x markup
91035Monitoring and recording of esophageal function through a capsule attached to the esophagus wallโš  5.3x markup
$2.0K
11 services$179.57/svc5.32x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
45385Removal of polyps or growths of large bowel using an endoscope8.6K$2.9M$344.382.73x
45380Biopsy of large bowel using an endoscope6.7K$1.7M$253.523.75x
43239Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope7.1K$1.4M$201.174.11x
43249Balloon dilation of esophagus using an endoscope2.6K$1.2M$462.662.09x
G0105Colorectal cancer screening; colonoscopy on individual at high risk1.4K$465.5K$333.902.51x
G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk836$280.1K$335.072.54x
45378Diagnostic examination of large bowel using an endoscope880$216.9K$246.483.95x
45390Removal of large bowel tissue using an endoscope206$165.9K$805.462.10x
44361Biopsy of small bowel using an endoscope102$32.2K$315.231.97x
43235Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope131$30.7K$234.733.64x
45381Injections of large bowel using an endoscope134$21.7K$161.722.70x
45384Removal of polyps or growths in large bowel using an endoscope51$13.2K$259.403.37x
43245Dilation of stomach outlet using an endoscope28$10.9K$388.162.42x
91035Monitoring and recording of esophageal function through a capsule attached to the esophagus wall11$2.0K$179.575.32x

Markup Analysis

Charge-to-Payment Ratio

3.08x

This provider submits charges 3.08 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.08x means for every $100 Medicare pays, this provider initially charges $308. This is higher than the national average.

Location

Hendersonville, NC

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Ambulatory Surgical Center providers in NC for peer comparison.

Carolina Mountain Gastroenterology Endoscopy Center (you)
$8.5M
The Eye Surgery Center Of The Carolinas Lp
$33.8M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
The Eye Surgery Center Of The Carolinas LpSouthern Pines, NC$33.8Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

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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