This provider's $3.5M in total Medicare payments ranks in the 99th percentile of General Surgery providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $433.02 | $138.37 | 3.13x | $294.65 | $314.8K | 4.7K | 4.0K |
| 2015 | $406.77 | $132.01 | 3.08x | $274.76 | $284.8K | 4.2K | 3.6K |
| 2016 | $346.33 | $106.60 | 3.25x | $239.73 | $243.6K | 4.0K | 3.6K |
| 2017 | $415.28 | $137.15 | 3.03x | $278.13 | $266.1K | 3.8K | 3.3K |
| 2018 | $476.37 | $148.49 | 3.21x | $327.88 | $315.5K | 4.3K | 3.7K |
| 2019 | $588.42 | $177.17 | 3.32x | $411.25 | $393.3K | 5.1K | 4.4K |
| 2020 | $578.82 | $206.64 | 2.80x | $372.18 | $347.5K | 4.1K | 3.5K |
| 2021 | $557.91 | $203.49 | 2.74x | $354.42 | $435.1K | 4.3K | 3.8K |
| 2022 | $485.47 | $167.55 | 2.90x | $317.92 | $427.4K | 4.3K | 3.5K |
| 2023 | $489.07 | $171.83 | 2.85x | $317.24 | $459.5K | 5.2K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 76641 | Ultrasound of one breast | 7.0K | $679.7K | $96.74 | 2.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.2K | $549.2K | $53.63 | 2.53x |
| 77067 | Mammography of both breasts | 3.0K | $313.7K | $103.35 | 2.42x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $279.5K | $91.93 | 2.79x |
| 76377 | 3D radiographic procedure with computerized image postprocessing | 4.0K | $210.0K | $52.26 | 5.58x |
| 19083 | Biopsy of breast accessed throught the skin with ultrasound guidance | 364 | $184.4K | $506.66 | 2.71x |
| G0202 | Screening mammography, producing direct digital image, bilateral, all views | 1.5K | $159.3K | $103.02 | 2.10x |
| 77066 | Mammography of both breasts | 1.5K | $146.3K | $95.95 | 3.46x |
| 19301 | Partial removal of breast | 232 | $118.1K | $509.03 | 2.61x |
| 19081 | Biopsy of breast accessed throught the skin with stereotactic guidance | 171 | $90.3K | $528.23 | 2.70x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.0K | $78.5K | $77.60 | 2.58x |
| 77065 | Mammography of one breast | 1.1K | $78.4K | $72.16 | 3.51x |
| G0204 | Diagnostic mammography, producing direct digital image, bilateral, all views | 717 | $69.0K | $96.20 | 2.72x |
| G0206 | Diagnostic mammography, producing direct digital image, unilateral, all views | 725 | $53.2K | $73.39 | 2.78x |
| 76645 | Ultrasound of breasts | 652 | $51.9K | $79.62 | 3.34x |
| 19302 | Partial removal of breast and underarm lymph nodes | 69 | $50.6K | $733.45 | 2.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 382 | $45.0K | $117.72 | 2.85x |
| 77085 | Bone density measurement using dedicated X-ray machine | 870 | $42.7K | $49.10 | 2.43x |
| 76982 | Elastography ultrasound of first lesion | 542 | $42.0K | $77.54 | 2.81x |
| 19285 | Placement of breast localization devices accessed through the skin with ultrasound guidance | 154 | $40.7K | $264.23 | 3.86x |
This provider submits charges 2.95 times higher than what Medicare actually pays.
A markup ratio of 2.95x means for every $100 Medicare pays, this provider initially charges $295. 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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