This provider's $3.6M in total Medicare payments ranks in the 91th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.72x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 1230% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 249% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $33.4K | $4.5K | 7.48x | $29.0K | $133.9K | 32 | 32 |
| 2021 | $39.3K | $5.5K | 7.17x | $33.8K | $466.9K | 94 | 93 |
| 2022 | $30.3K | $4.2K | 7.19x | $26.1K | $1.2M | 209 | 206 |
| 2023 | $25.2K | $3.6K | 7.00x | $21.6K | $1.8M | 306 | 297 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 270 | $1.9M | $6.9K | 6.44x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 184 | $1.3M | $7.1K | 6.23x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 125 | $274.9K | $2.2K | 10.35x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach, complex | 11 | $66.6K | $6.1K | 7.33x |
| 58558 | Biopsy of lining of uterus and/or removal of polyp using an endoscope | 40 | $40.3K | $1.0K | 9.64x |
| 27570 | Manipulation of knee joint under anesthesia | 11 | $6.3K | $571.21 | 9.45x |
This provider submits charges 6.72 times higher than what Medicare actually pays.
A markup ratio of 6.72x means for every $100 Medicare pays, this provider initially charges $672. 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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