⚠️ This provider averages 1.3K services per working day — physically unusual for an individual practitioner
Based on 3.4M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $11.7M in total Medicare payments ranks in the 99th percentile of Urology providers nationally.
Averaging 1.3K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 431% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 198% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $191.59 | $46.48 | 4.12x | $145.11 | $559.4K | 12.0K | 33 |
| 2015 | $11.73 | $2.74 | 4.28x | $8.99 | $540.7K | 197.6K | 29 |
| 2016 | $10.97 | $2.59 | 4.24x | $8.38 | $637.1K | 246.5K | 30 |
| 2017 | $7.73 | $1.87 | 4.13x | $5.86 | $686.8K | 367.2K | 31 |
| 2018 | $7.78 | $1.87 | 4.16x | $5.91 | $640.4K | 342.1K | 27 |
| 2019 | $6.34 | $1.59 | 3.99x | $4.75 | $615.3K | 388.1K | 30 |
| 2020 | $6.68 | $1.71 | 3.91x | $4.97 | $653.2K | 381.6K | 25 |
| 2021 | $11.88 | $4.21 | 2.82x | $7.67 | $1.9M | 462.1K | 25 |
| 2022 | $14.96 | $5.32 | 2.81x | $9.64 | $2.5M | 461.9K | 24 |
| 2023 | $16.97 | $6.03 | 2.81x | $10.94 | $3.0M | 493.0K | 27 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87150 | Identification of organisms by genetic analysis, amplified probe technique | 69.4K | $2.4M | $34.42 | 2.56x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 27.0K | $2.2M | $79.80 | 3.91x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 17.4K | $1.2M | $68.84 | 2.54x |
| 52224 | Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm | 1.7K | $963.9K | $560.38 | 3.53x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 8.8K | $510.4K | $58.25 | 3.66x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 11.6K | $398.9K | $34.43 | 1.28x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 11.6K | $398.8K | $34.42 | 2.91x |
| 50590 | Shock wave crushing of kidney stones | 633 | $276.1K | $436.22 | 3.89x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 1.6K | $257.5K | $160.32 | 4.19x |
| 52649 | Laser fragmentation of prostate tissue with control of bleeding using an endoscope | 377 | $236.9K | $628.48 | 3.91x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.0K | $224.3K | $112.39 | 4.24x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.6K | $201.6K | $78.60 | 3.91x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 5.8K | $199.8K | $34.42 | 2.56x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 5.8K | $199.8K | $34.42 | 2.91x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 5.8K | $199.8K | $34.42 | 2.56x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 5.8K | $199.7K | $34.42 | 2.56x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 5.8K | $199.7K | $34.41 | 2.56x |
| 51729 | Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies | 737 | $185.2K | $251.34 | 3.84x |
| 96372 | Injection of drug or substance under skin or into muscle | 11.0K | $145.5K | $13.26 | 5.47x |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 1.2K | $131.0K | $108.98 | 4.96x |
This provider submits charges 3.3 times higher than what Medicare actually pays.
A markup ratio of 3.3x means for every $100 Medicare pays, this provider initially charges $330. 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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