This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 6015% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 553% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $266.43 | $60.04 | 4.44x | $206.39 | $13.6K | 241 | 237 |
| 2017 | $235.26 | $49.84 | 4.72x | $185.42 | $88.9K | 1.6K | 1.5K |
| 2018 | $199.12 | $60.13 | 3.31x | $138.99 | $164.4K | 2.6K | 2.6K |
| 2019 | $102.50 | $62.84 | 1.63x | $39.66 | $1.0M | 16.6K | 16.4K |
| 2020 | $103.32 | $64.45 | 1.60x | $38.87 | $577.7K | 8.8K | 8.7K |
| 2021 | $105.00 | $67.51 | 1.56x | $37.49 | $806.4K | 11.6K | 11.5K |
| 2022 | $105.15 | $65.64 | 1.60x | $39.51 | $792.8K | 11.4K | 11.3K |
| 2023 | $105.14 | $62.72 | 1.68x | $42.42 | $832.8K | 12.6K | 12.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 22.2K | $1.9M | $84.48 | 1.34x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 29.1K | $1.6M | $53.37 | 2.38x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 10.1K | $626.4K | $61.94 | 1.31x |
| 88342 | Tissue or cell analysis by immunologic technique | 1.5K | $121.9K | $82.60 | 2.01x |
| 88341 | Special stained specimen slides to examine tissue | 1.2K | $86.4K | $71.80 | 1.79x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 1.0K | $32.0K | $30.90 | 2.63x |
| 88323 | Surgical pathology consultation and report | 117 | $12.2K | $103.89 | 3.85x |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 34 | $2.4K | $71.60 | 5.59x |
| 88321 | Surgical pathology consultation and report | 25 | $2.0K | $79.64 | 4.08x |
| 85060 | Blood smear interpretation by physician with written report | 86 | $1.8K | $20.66 | 4.12x |
| 88360 | Microscopic genetic analysis of tumor | 12 | $1.4K | $118.84 | 3.24x |
| 88112 | Cell examination of specimen | 45 | $1.0K | $23.17 | 11.22x |
| 88311 | Preparation of tissue for examination by removing any calcium present | 16 | $172.14 | $10.76 | 6.97x |
| 88300 | Pathology examination of tissue using a microscope, limited examination | 32 | $111.00 | $3.47 | 17.30x |
This provider submits charges 1.76 times higher than what Medicare actually pays.
A markup ratio of 1.76x means for every $100 Medicare pays, this provider initially charges $176. This is lower 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 Pathology providers in GA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Scott Acker, MD | Alpharetta, GA | $50.6M | ✓ 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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