This provider's $3.3M in total Medicare payments ranks in the 90th percentile of Ambulatory Surgical Center providers nationally.
Medicare payments to this provider grew 71% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 127% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $14.5K | $3.2K | 4.51x | $11.3K | $661.3K | 337 | 318 |
| 2022 | $10.4K | $2.2K | 4.83x | $8.3K | $1.5M | 691 | 575 |
| 2023 | $10.9K | $2.7K | 4.12x | $8.3K | $1.1M | 604 | 485 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64590 | Insertion or replacement of peripheral or gastric neurostimulator generator | 78 | $1.1M | $14.2K | 4.18x |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 177 | $957.9K | $5.4K | 4.73x |
| 64561 | Insertion of sacral nerve neurostimulator electrodes, accessed through the skin | 180 | $656.2K | $3.6K | 4.14x |
| 52005 | Insertion of catheter into urinary duct (ureter) using an endoscope through the bladder area | 196 | $109.9K | $560.61 | 5.24x |
| 52260 | Dilation of the bladder using an endoscope under general or spinal anesthesia | 154 | $94.4K | $613.20 | 4.82x |
| 55700 | Biopsy of prostate gland | 140 | $83.7K | $597.60 | 4.93x |
| 74420 | Imaging of urinary tract | 411 | $60.0K | $146.05 | 4.66x |
| 50590 | Shock wave crushing of kidney stones | 43 | $47.5K | $1.1K | 8.11x |
| 52356 | Crushing of stone of ureter with insertion of stent using an endoscope | 30 | $47.4K | $1.6K | 4.99x |
| 64581 | Incision to insert sacral nerve neurostimulator electrodes | 12 | $45.2K | $3.8K | 4.48x |
| 52332 | Insertion of stent in ureter using an endoscope | 40 | $34.7K | $867.18 | 6.10x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 117 | $17.6K | $150.33 | 6.94x |
| 52351 | Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope | 15 | $16.6K | $1.1K | 4.67x |
| 52224 | Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm | 13 | $12.7K | $978.86 | 5.27x |
| 52287 | Exam with injections of chemical for destruction of bladder using an endoscope | 13 | $7.8K | $603.19 | 4.88x |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 13 | $63.58 | $4.89 | 4.60x |
This provider submits charges 4.53 times higher than what Medicare actually pays.
A markup ratio of 4.53x means for every $100 Medicare pays, this provider initially charges $453. 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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