This provider's $36.4M in total Medicare payments ranks in the 99th 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.
Notable: Payments increased 50% in 2017
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 | $2.8K | $772.18 | 3.61x | $2.0K | $3.4M | 4.4K | 3.1K |
| 2015 | $2.3K | $772.09 | 3.00x | $1.5K | $3.6M | 4.7K | 3.2K |
| 2016 | $1.6K | $772.19 | 2.02x | $791.43 | $2.6M | 3.4K | 2.3K |
| 2017 | $2.9K | $772.20 | 3.72x | $2.1K | $3.9M | 5.1K | 3.5K |
| 2018 | $1.5K | $772.20 | 1.92x | $707.64 | $2.8M | 3.7K | 2.6K |
| 2019 | $1.8K | $772.11 | 2.35x | $1.0K | $2.8M | 3.6K | 2.5K |
| 2020 | $2.0K | $772.11 | 2.61x | $1.2K | $3.7M | 4.8K | 3.3K |
| 2021 | $1.8K | $772.18 | 2.32x | $1.0K | $4.8M | 6.2K | 4.3K |
| 2022 | $2.0K | $772.17 | 2.55x | $1.2K | $4.9M | 6.4K | 4.4K |
| 2023 | $1.7K | $772.13 | 2.21x | $930.96 | $3.9M | 5.0K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, low complexity | 16.3K | $9.0M | $552.05 | 1.88x |
| 99214 | Office/outpatient visit, moderate complexity | 10.7K | $5.9M | $551.59 | 2.06x |
| 99203 | Office/outpatient visit, new patient | 5.6K | $3.6M | $646.80 | 2.70x |
| 99215 | Office/outpatient visit, high complexity | 3.3K | $2.4M | $717.36 | 2.38x |
| 36415 | Insertion of needle into vein for blood collection | 2.7K | $2.2M | $825.91 | 2.60x |
| 93000 | Electrocardiogram with interpretation | 2.6K | $1.6M | $626.88 | 3.47x |
| 80053 | Comprehensive metabolic panel | 3.1K | $1.6M | $529.73 | 4.34x |
| 71046 | Chest X-ray, 2 views | 1.9K | $1.1M | $597.02 | 3.25x |
| 85025 | Complete blood cell count | 729 | $1.0M | $1.4K | 4.16x |
| 96372 | Therapeutic injection | 930 | $630.6K | $678.05 | 2.52x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower 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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