This provider's $6.8M in total Medicare payments ranks in the 95th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.07x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 249% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 57% 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 |
|---|---|---|---|---|---|---|---|
| 2015 | $3.7K | $888.35 | 4.11x | $2.8K | $363.8K | 546 | 532 |
| 2016 | $3.4K | $812.91 | 4.18x | $2.6K | $505.7K | 817 | 801 |
| 2017 | $3.6K | $810.35 | 4.44x | $2.8K | $582.5K | 974 | 942 |
| 2018 | $3.9K | $724.57 | 5.33x | $3.1K | $739.2K | 1.3K | 1.3K |
| 2019 | $4.0K | $757.99 | 5.30x | $3.3K | $765.0K | 1.4K | 1.3K |
| 2020 | $4.3K | $817.77 | 5.30x | $3.5K | $626.8K | 1.0K | 999 |
| 2021 | $4.3K | $908.90 | 4.78x | $3.4K | $984.4K | 1.5K | 1.4K |
| 2022 | $4.5K | $936.75 | 4.82x | $3.6K | $990.8K | 1.5K | 1.4K |
| 2023 | $4.8K | $1.1K | 4.38x | $3.7K | $1.3M | 1.7K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45380 | Biopsy of large bowel using an endoscope | 2.3K | $974.2K | $429.54 | 5.40x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 1.4K | $761.1K | $543.65 | 4.50x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 133 | $582.2K | $4.4K | 2.72x |
| 29881 | Removal of one knee cartilage using an endoscope | 337 | $462.7K | $1.4K | 4.40x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 1.4K | $451.6K | $313.38 | 6.90x |
| 29848 | Release of wrist ligament using an endoscope | 468 | $378.4K | $808.62 | 6.40x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 88 | $245.9K | $2.8K | 3.59x |
| 29880 | Removal of both knee cartilages using an endoscope | 166 | $230.6K | $1.4K | 5.11x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 539 | $224.0K | $415.59 | 3.65x |
| 43259 | Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope | 273 | $199.4K | $730.43 | 4.44x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 150 | $172.7K | $1.2K | 6.95x |
| 29876 | Removal of joint lining from two or more knee joint compartments using an endoscope | 236 | $166.6K | $705.88 | 9.03x |
| 20680 | Removal of deep bone implant | 145 | $160.2K | $1.1K | 3.94x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 300 | $155.2K | $517.34 | 4.48x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 180 | $144.8K | $804.67 | 12.17x |
| 26055 | Incision of tendon covering | 237 | $144.5K | $609.76 | 5.66x |
| 43237 | Ultrasound examination of esophagus, stomach, and/or upper small bowel using an endoscope | 167 | $102.1K | $611.43 | 5.59x |
| 43252 | Microscopic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 55 | $87.6K | $1.6K | 1.70x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance, single level | 207 | $85.0K | $410.67 | 5.04x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 163 | $84.5K | $518.21 | 4.42x |
This provider submits charges 5.07 times higher than what Medicare actually pays.
A markup ratio of 5.07x means for every $100 Medicare pays, this provider initially charges $507. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Specialty Surgical Center, Llc | Beverly Hills, CA | $49.2M | ✓ Clear |
| Santa Rosa Surgery Center L P | Santa Rosa, CA | $41.3M | ✓ Clear |
| Peninsula Eye Surgery Center Llc | Mountain View, CA | $37.0M | ✓ Clear |
| Fort Sutter Surgery Center A California Limited Partnership | Sacramento, CA | $33.6M | ✓ Clear |
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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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