This provider's $3.7M in total Medicare payments ranks in the 99th percentile of General Surgery 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 | $560.57 | $145.52 | 3.85x | $415.05 | $286.9K | 3.4K | 2.3K |
| 2015 | $698.98 | $163.58 | 4.27x | $535.40 | $323.0K | 3.6K | 2.5K |
| 2016 | $714.87 | $172.30 | 4.15x | $542.57 | $321.3K | 3.6K | 2.4K |
| 2017 | $660.80 | $147.30 | 4.49x | $513.50 | $337.9K | 4.0K | 2.6K |
| 2018 | $715.79 | $158.23 | 4.52x | $557.56 | $422.6K | 4.8K | 3.0K |
| 2019 | $806.67 | $181.65 | 4.44x | $625.02 | $482.6K | 5.2K | 3.1K |
| 2020 | $763.65 | $161.66 | 4.72x | $601.99 | $375.9K | 4.0K | 2.4K |
| 2021 | $750.49 | $163.24 | 4.60x | $587.25 | $390.4K | 3.6K | 2.3K |
| 2022 | $901.91 | $187.81 | 4.80x | $714.10 | $379.5K | 3.5K | 2.4K |
| 2023 | $730.98 | $141.06 | 5.18x | $589.92 | $372.5K | 3.5K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.8K | $704.2K | $59.76 | 2.96x |
| 46221 | Removal of hemorrhoid by rubber banding | 2.0K | $468.7K | $232.84 | 2.62x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.6K | $342.0K | $95.90 | 2.91x |
| 45388 | Destruction of large bowel growths using an endoscope | 1.3K | $295.9K | $232.80 | 5.20x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 2.0K | $201.3K | $99.77 | 2.99x |
| 76705 | Ultrasound of abdomen | 2.5K | $188.5K | $76.05 | 3.16x |
| 15734 | Muscle flap wound repair at trunk | 111 | $116.6K | $1.1K | 3.73x |
| 49507 | Repair of trapped groin hernia patient age 5 years or older | 218 | $112.2K | $514.47 | 3.39x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 1.5K | $104.7K | $68.07 | 23.50x |
| 49561 | Repair of trapped incisional or abdominal hernia | 141 | $85.6K | $606.85 | 3.73x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 892 | $76.7K | $86.00 | 17.66x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.3K | $76.5K | $60.83 | 3.02x |
| 43250 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 812 | $76.3K | $94.02 | 8.93x |
| 17250 | Application of chemical agent to excessive wound tissue | 1.8K | $67.6K | $37.93 | 6.28x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.8K | $66.8K | $37.02 | 2.93x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 667 | $55.8K | $83.64 | 3.09x |
| 49568 | Placement of mesh to repair incisional or abdominal hernia, open procedure | 226 | $52.6K | $232.84 | 2.51x |
| 47562 | Removal of gallbladder using an endoscope | 104 | $48.6K | $467.06 | 4.49x |
| 44050 | Incisional repair of twisted or herniated small bowel | 65 | $44.8K | $689.20 | 3.13x |
| 10061 | Drainage of multiple abscess | 228 | $40.0K | $175.34 | 3.47x |
This provider submits charges 4.83 times higher than what Medicare actually pays.
A markup ratio of 4.83x means for every $100 Medicare pays, this provider initially charges $483. 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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