This provider's $4.3M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Medicare payments to this provider grew 95% from 2014 to 2023.
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 | $375.81 | $122.63 | 3.06x | $253.18 | $366.7K | 8.1K | 5.4K |
| 2015 | $282.35 | $85.58 | 3.30x | $196.77 | $352.6K | 8.2K | 5.4K |
| 2016 | $342.18 | $96.08 | 3.56x | $246.10 | $404.7K | 9.0K | 5.8K |
| 2017 | $338.36 | $101.30 | 3.34x | $237.06 | $431.9K | 9.5K | 6.1K |
| 2018 | $345.70 | $100.56 | 3.44x | $245.14 | $394.5K | 8.8K | 6.0K |
| 2019 | $358.36 | $99.95 | 3.59x | $258.41 | $353.8K | 8.2K | 5.8K |
| 2020 | $362.23 | $104.08 | 3.48x | $258.15 | $359.2K | 8.3K | 6.0K |
| 2021 | $383.40 | $112.44 | 3.41x | $270.96 | $376.9K | 7.6K | 5.4K |
| 2022 | $309.63 | $77.89 | 3.98x | $231.74 | $556.5K | 12.8K | 9.0K |
| 2023 | $314.16 | $78.44 | 4.01x | $235.72 | $714.1K | 17.1K | 10.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.7K | $1.2M | $81.73 | 2.16x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.4K | $427.6K | $57.72 | 2.08x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 2.1K | $320.4K | $154.92 | 2.59x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $255.5K | $120.18 | 2.11x |
| 76857 | Ultrasound of pelvis | 5.7K | $199.0K | $34.86 | 3.14x |
| 64561 | Insertion of sacral nerve neurostimulator electrodes, accessed through the skin | 466 | $175.2K | $375.97 | 4.31x |
| 64581 | Incision to insert sacral nerve neurostimulator electrodes | 203 | $109.2K | $537.88 | 2.68x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 1.5K | $103.5K | $68.80 | 2.03x |
| 50590 | Shock wave crushing of kidney stones | 217 | $99.2K | $457.05 | 3.81x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 10.1K | $97.2K | $9.59 | 2.94x |
| 81002 | Urinalysis, manual test | 25.5K | $86.3K | $3.39 | 2.07x |
| 51700 | Bladder irrigation and/or instillation | 2.1K | $78.4K | $36.65 | 4.26x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 954 | $74.4K | $78.03 | 2.14x |
| 51701 | Insertion of temporary bladder catheter | 1.7K | $64.0K | $37.49 | 2.73x |
| 95972 | Electronic analysis and programming of implanted complex spinal cord or peripheral neurostimulator generator system during or after surgery, first hour | 1.3K | $54.2K | $42.37 | 3.38x |
| J3315 | Injection, triptorelin pamoate, 3.75 mg | 240 | $52.9K | $220.56 | 2.91x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 527 | $51.8K | $98.27 | 2.53x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 1.5K | $51.7K | $34.39 | 2.38x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 1.5K | $51.7K | $34.39 | 2.04x |
| 87150 | Identification of organisms by genetic analysis, amplified probe technique | 1.5K | $51.7K | $34.39 | 2.04x |
This provider submits charges 2.6 times higher than what Medicare actually pays.
A markup ratio of 2.6x means for every $100 Medicare pays, this provider initially charges $260. 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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