This provider's $4.6M in total Medicare payments ranks in the 93th percentile of Ambulatory Surgical Center 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 | $699.67 | $368.24 | 1.90x | $331.43 | $451.1K | 1.3K | 1.3K |
| 2015 | $700.16 | $394.77 | 1.77x | $305.39 | $419.6K | 1.1K | 1.1K |
| 2016 | $699.84 | $414.13 | 1.69x | $285.71 | $383.4K | 1.0K | 1.0K |
| 2017 | $697.14 | $409.01 | 1.70x | $288.13 | $385.8K | 1.1K | 1.1K |
| 2018 | $991.38 | $429.47 | 2.31x | $561.91 | $368.6K | 1.0K | 1.0K |
| 2019 | $1.1K | $450.12 | 2.43x | $642.32 | $502.2K | 1.3K | 1.3K |
| 2020 | $1.3K | $619.80 | 2.17x | $726.28 | $494.3K | 1.1K | 1.1K |
| 2021 | $1.4K | $689.30 | 2.08x | $744.22 | $659.8K | 1.5K | 1.5K |
| 2022 | $1.2K | $522.69 | 2.35x | $704.13 | $551.3K | 1.3K | 1.3K |
| 2023 | $1.2K | $542.65 | 2.26x | $682.28 | $413.5K | 977 | 942 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 5.3K | $1.8M | $340.46 | 2.44x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 1.8K | $672.8K | $364.45 | 2.72x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.2K | $417.6K | $339.54 | 2.60x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 1.0K | $378.1K | $369.59 | 2.32x |
| 66984 | Removal of cataract with insertion of lens | 431 | $364.9K | $846.58 | 1.94x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 729 | $312.0K | $427.97 | 2.05x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 601 | $243.7K | $405.51 | 2.21x |
| 43250 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 266 | $142.3K | $534.85 | 1.62x |
| 65820 | Incision to improve eye fluid flow | 50 | $69.2K | $1.4K | 1.81x |
| 45390 | Removal of large bowel tissue using a flexible endoscope (colonoscopy) | 61 | $65.7K | $1.1K | 2.27x |
| 45380 | Biopsy of large bowel using an endoscope | 145 | $51.7K | $356.59 | 2.75x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 53 | $29.6K | $557.93 | 1.56x |
| 66174 | Dilation to improve eye fluid flow | 17 | $27.6K | $1.6K | 1.54x |
| 52240 | Destruction and/or removal of large growths of the bladder using an endoscope | 14 | $26.6K | $1.9K | 1.32x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 39 | $21.8K | $558.17 | 2.66x |
| 66982 | Complex removal of cataract with insertion of lens | 13 | $10.0K | $769.10 | 1.95x |
| 52204 | Biopsy of the bladder using an endoscope | 15 | $5.9K | $393.10 | 3.82x |
This provider submits charges 2.36 times higher than what Medicare actually pays.
A markup ratio of 2.36x means for every $100 Medicare pays, this provider initially charges $236. 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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