This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 327% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 531% in 2023
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 | $162.29 | $68.05 | 2.38x | $94.24 | $175.1K | 4.4K | 3.7K |
| 2015 | $268.57 | $104.01 | 2.58x | $164.56 | $376.7K | 5.6K | 4.8K |
| 2016 | $278.86 | $109.16 | 2.55x | $169.70 | $377.7K | 5.3K | 4.6K |
| 2017 | $248.44 | $93.32 | 2.66x | $155.12 | $384.2K | 6.5K | 5.9K |
| 2018 | $525.83 | $187.32 | 2.81x | $338.51 | $620.6K | 5.9K | 5.7K |
| 2019 | $530.05 | $174.48 | 3.04x | $355.57 | $899.2K | 8.1K | 7.6K |
| 2020 | $532.05 | $170.81 | 3.11x | $361.24 | $827.5K | 7.2K | 6.7K |
| 2021 | $530.69 | $177.12 | 3.00x | $353.57 | $763.2K | 7.0K | 6.5K |
| 2022 | $276.59 | $94.06 | 2.94x | $182.53 | $118.5K | 2.5K | 2.5K |
| 2023 | $526.04 | $168.62 | 3.12x | $357.42 | $748.0K | 6.0K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88121 | Cell examination of urine | 4.1K | $1.6M | $394.72 | 2.63x |
| 88112 | Cell examination of specimen | 24.9K | $1.3M | $51.20 | 3.80x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens | 3.0K | $1.1M | $358.84 | 3.67x |
| 88120 | Cell examination of urine | 1.4K | $453.0K | $335.31 | 2.36x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 12.3K | $429.0K | $34.98 | 3.36x |
| 88342 | Tissue or cell analysis by immunologic technique | 5.2K | $190.9K | $36.44 | 3.72x |
| 88344 | Special stained specimen slides to examine tissue | 781 | $110.6K | $141.66 | 2.05x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 5.8K | $87.2K | $15.01 | 3.67x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 366 | $29.1K | $79.64 | 2.76x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 442 | $12.7K | $28.65 | 4.48x |
| 88341 | Special stained specimen slides to examine tissue | 193 | $12.6K | $65.25 | 2.59x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 56 | $1.7K | $30.00 | 2.00x |
This provider submits charges 3.21 times higher than what Medicare actually pays.
A markup ratio of 3.21x means for every $100 Medicare pays, this provider initially charges $321. 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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