This provider's $5.6M in total Medicare payments ranks in the 99th 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 | $276.04 | $189.33 | 1.46x | $86.71 | $466.9K | 7.1K | 4.7K |
| 2015 | $301.29 | $209.17 | 1.44x | $92.12 | $535.1K | 9.3K | 6.0K |
| 2016 | $334.93 | $212.68 | 1.57x | $122.25 | $631.4K | 11.8K | 6.9K |
| 2017 | $507.31 | $267.55 | 1.90x | $239.76 | $713.6K | 12.5K | 7.3K |
| 2018 | $367.33 | $222.36 | 1.65x | $144.97 | $659.5K | 13.9K | 7.7K |
| 2019 | $262.62 | $140.85 | 1.86x | $121.77 | $597.5K | 12.3K | 7.1K |
| 2020 | $208.78 | $116.39 | 1.79x | $92.39 | $487.5K | 10.9K | 5.8K |
| 2021 | $204.37 | $121.60 | 1.68x | $82.77 | $565.2K | 10.9K | 5.8K |
| 2022 | $204.10 | $113.97 | 1.79x | $90.13 | $478.3K | 10.0K | 5.4K |
| 2023 | $223.95 | $115.11 | 1.95x | $108.84 | $426.8K | 9.5K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 29.4K | $1.9M | $64.57 | 2.08x |
| 76872 | Ultrasound of rectum | 7.7K | $752.5K | $97.82 | 1.46x |
| 76705 | Ultrasound of abdomen | 7.6K | $634.0K | $83.25 | 1.83x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 1.4K | $360.8K | $264.14 | 1.41x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.7K | $241.9K | $88.43 | 2.19x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 1.3K | $205.5K | $157.09 | 2.16x |
| 51741 | Electronic assessment of bladder emptying | 16.5K | $204.5K | $12.42 | 3.68x |
| 53850 | Destruction of prostate tissue through bladder canal (urethra) | 108 | $200.9K | $1.9K | 1.34x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 295 | $198.8K | $673.90 | 1.42x |
| 76700 | Ultrasound of abdomen | 1.3K | $146.7K | $111.46 | 1.62x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 10.6K | $126.7K | $11.92 | 4.03x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 653 | $115.8K | $177.30 | 1.48x |
| 81000 | Manual urinalysis test with examination using microscope | 21.7K | $88.1K | $4.06 | 2.24x |
| 76856 | Ultrasound of pelvis | 1.3K | $79.9K | $62.40 | 2.46x |
| 54405 | Insertion of multi-component inflatable penile prosthesis | 88 | $59.5K | $676.50 | 1.45x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 207 | $50.3K | $242.80 | 1.52x |
| 51703 | Insertion of indwelling bladder catheter | 355 | $42.2K | $118.91 | 1.71x |
| 54360 | Reconstructive surgery to correct angle penis | 78 | $24.3K | $311.35 | 2.80x |
| 52441 | Insertion of implant material in bladder using an endoscope | 19 | $21.6K | $1.1K | 2.21x |
| 54235 | Injection procedure to induce erection | 239 | $17.7K | $74.08 | 1.85x |
This provider submits charges 1.97 times higher than what Medicare actually pays.
A markup ratio of 1.97x means for every $100 Medicare pays, this provider initially charges $197. This is lower 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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