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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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Methodology•Download Data
  1. Home
  2. Providers
  3. Sutter Bay Medical Foundation
🔪
Organization

Sutter Bay Medical Foundation

NPI: 1104067115
Palo Alto, CA
10 years of data
Ambulatory Surgical Center
$22.4M
Total Payments
236
Beneficiaries
62.0K
Services
4.3x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$22.4M
Specialty median$657.1K

📋 Key Findings

1Billed $22.4M over 10 years
24.3x markup ratio (above median)
399th percentile in Ambulatory Surgical Center by payments
417 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $22.4M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.

Medicare payments to this provider grew 77% 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 — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$2.6K$587.034.37x$2.0K$1.7M2.9K22
2015$2.4K$564.984.18x$1.8K$1.7M3.0K19
2016$2.3K$566.284.08x$1.7K$1.8M3.2K21
2017$2.6K$611.014.21x$2.0K$2.0M3.2K23
2018$3.0K$630.304.71x$2.3K$2.3M3.6K23
2019$3.0K$641.184.61x$2.3K$2.5M3.8K27
2020$1.5K$332.024.37x$1.1K$1.9M5.7K23
2021$1.0K$238.384.27x$780.20$2.5M10.7K26
2022$1.0K$247.264.15x$779.53$3.0M12.2K26
2023$913.38$222.654.10x$690.73$3.0M13.6K26

Top Procedures (20)

66984Removal of cataract with insertion of prosthetic lens⚠ 3.7x markup
$6.8M
6.1K services$1.1K/svc3.74x markup
45385Removal of polyps or growths of large bowel using an endoscope with mechanical snare⚠ 4.4x markup
$3.3M
6.2K services$543.37/svc4.44x markup
45380Biopsy of large bowel using a flexible endoscope⚠ 5.4x markup
$3.1M
7.6K services$410.97/svc5.36x markup
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope⚠ 6.0x markup
$1.0M
3.1K services$332.38/svc6.03x markup
49505Repair of groin hernia (5 years or older)⚠ 3.6x markup
$788.2K
522 services$1.5K/svc3.61x markup
G0105Colorectal cancer screening; colonoscopy on individual at high risk⚠ 4.4x markup
$659.7K
1.3K services$527.30/svc4.36x markup
15823Removal of excessive skin and fat of upper eyelid⚠ 4.9x markup
$536.2K
772 services$694.52/svc4.93x markup
66982Complex removal of cataract with insertion of prosthetic lens⚠ 3.8x markup
$413.2K
380 services$1.1K/svc3.76x markup
G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk⚠ 4.5x markup
$404.4K
791 services$511.20/svc4.45x markup
67904Repair of tendon of upper eyelid⚠ 4.4x markup
$377.4K
534 services$706.69/svc4.42x markup
67041Removal of membrane of retina
$308.6K
147 services$2.1K/svc2.81x markup
19301Partial removal of breast⚠ 4.6x markup
$293.2K
317 services$924.99/svc4.59x markup
66991Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye⚠ 3.8x markup
$284.1K
76 services$3.7K/svc3.83x markup
45381Injection beneath lining of large bowel using a flexible endoscope⚠ 6.7x markup
$254.7K
933 services$272.96/svc6.66x markup
43249Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm⚠ 4.3x markup
$247.2K
348 services$710.25/svc4.32x markup
64483Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level⚠ 3.7x markup
$242.7K
592 services$409.90/svc3.68x markup
58558Biopsy of lining of uterus and/or removal of polyp using an endoscope⚠ 4.6x markup
$223.0K
175 services$1.3K/svc4.61x markup
47562Removal of gallbladder using an endoscope⚠ 3.4x markup
$215.8K
85 services$2.5K/svc3.43x markup
45390Removal of large bowel tissue using a flexible endoscope
$214.4K
178 services$1.2K/svc1.57x markup
66180Creation of shunt to improve eye fluid flow using tissue graft
$186.1K
68 services$2.7K/svc2.60x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
66984Removal of cataract with insertion of prosthetic lens6.1K$6.8M$1.1K3.74x
45385Removal of polyps or growths of large bowel using an endoscope with mechanical snare6.2K$3.3M$543.374.44x
45380Biopsy of large bowel using a flexible endoscope7.6K$3.1M$410.975.36x
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope3.1K$1.0M$332.386.03x
49505Repair of groin hernia (5 years or older)522$788.2K$1.5K3.61x
G0105Colorectal cancer screening; colonoscopy on individual at high risk1.3K$659.7K$527.304.36x
15823Removal of excessive skin and fat of upper eyelid772$536.2K$694.524.93x
66982Complex removal of cataract with insertion of prosthetic lens380$413.2K$1.1K3.76x
G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk791$404.4K$511.204.45x
67904Repair of tendon of upper eyelid534$377.4K$706.694.42x
67041Removal of membrane of retina147$308.6K$2.1K2.81x
19301Partial removal of breast317$293.2K$924.994.59x
66991Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye76$284.1K$3.7K3.83x
45381Injection beneath lining of large bowel using a flexible endoscope933$254.7K$272.966.66x
43249Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm348$247.2K$710.254.32x
64483Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level592$242.7K$409.903.68x
58558Biopsy of lining of uterus and/or removal of polyp using an endoscope175$223.0K$1.3K4.61x
47562Removal of gallbladder using an endoscope85$215.8K$2.5K3.43x
45390Removal of large bowel tissue using a flexible endoscope178$214.4K$1.2K1.57x
66180Creation of shunt to improve eye fluid flow using tissue graft68$186.1K$2.7K2.60x

Markup Analysis

Charge-to-Payment Ratio

4.3x

This provider submits charges 4.3 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.3x means for every $100 Medicare pays, this provider initially charges $430. This is higher than the national average.

Location

Palo Alto, CA

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 CA for peer comparison.

Sutter Bay Medical Foundation (you)
$22.4M
Specialty Surgical Center, Llc
$49.2M
Santa Rosa Surgery Center L P
$41.3M
Peninsula Eye Surgery Center Llc
$37.0M
Fort Sutter Surgery Center A California Limited Partnership
$33.6M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Specialty Surgical Center, LlcBeverly Hills, CA$49.2M✓ Clear
Santa Rosa Surgery Center L PSanta Rosa, CA$41.3M✓ Clear
Peninsula Eye Surgery Center LlcMountain View, CA$37.0M✓ Clear
Fort Sutter Surgery Center A California Limited PartnershipSacramento, CA$33.6M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • 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.

Believe this data is inaccurate? Dispute this data