This provider averages 54 services per working day
Based on 135.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $7.3M in total Medicare payments ranks in the 99th percentile of Gastroenterology providers nationally.
Averaging 54 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 61% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 116% in 2015
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 | $221.32 | $87.64 | 2.53x | $133.68 | $338.4K | 4.8K | 3.2K |
| 2015 | $223.31 | $92.15 | 2.42x | $131.16 | $729.6K | 11.2K | 6.7K |
| 2016 | $266.42 | $74.82 | 3.56x | $191.60 | $711.8K | 13.7K | 7.5K |
| 2017 | $212.41 | $66.58 | 3.19x | $145.83 | $829.6K | 17.6K | 9.3K |
| 2018 | $172.66 | $56.78 | 3.04x | $115.88 | $835.6K | 17.0K | 8.4K |
| 2019 | $160.93 | $59.80 | 2.69x | $101.13 | $845.4K | 17.5K | 9.6K |
| 2020 | $151.50 | $57.09 | 2.65x | $94.41 | $852.1K | 16.5K | 9.1K |
| 2021 | $207.56 | $60.66 | 3.42x | $146.90 | $846.6K | 16.3K | 9.6K |
| 2022 | $188.75 | $58.46 | 3.23x | $130.29 | $749.4K | 11.4K | 6.7K |
| 2023 | $207.70 | $52.73 | 3.94x | $154.97 | $543.6K | 9.6K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 22.4K | $1.5M | $66.20 | 1.89x |
| 76700 | Ultrasound of abdomen | 9.6K | $1.0M | $108.66 | 1.99x |
| 76536 | Ultrasound of head and neck | 9.2K | $962.2K | $104.84 | 2.01x |
| 76770 | Ultrasound behind abdominal cavity | 9.3K | $807.7K | $87.15 | 2.37x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 4.5K | $600.2K | $133.15 | 6.69x |
| 45380 | Biopsy of large bowel using an endoscope | 2.1K | $381.2K | $182.04 | 5.72x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 6.0K | $241.0K | $39.92 | 1.87x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 14.1K | $230.8K | $16.34 | 2.48x |
| 96360 | Hydration infusion into a vein 31 minutes to 1 hour | 4.6K | $187.5K | $40.74 | 2.58x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $180.2K | $139.18 | 1.88x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.7K | $98.7K | $59.78 | 2.34x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.3K | $96.7K | $76.58 | 1.99x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 693 | $92.5K | $133.47 | 1.60x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 447 | $81.5K | $182.42 | 1.61x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 270 | $72.1K | $267.04 | 4.32x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 415 | $68.6K | $165.39 | 1.95x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 754 | $67.1K | $89.00 | 1.69x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 1.9K | $55.9K | $29.27 | 2.15x |
| 96361 | Hydration infusion into a vein | 4.1K | $51.6K | $12.65 | 2.48x |
| G0008 | Administration of influenza virus vaccine | 1.8K | $43.9K | $24.72 | 1.58x |
This provider submits charges 2.77 times higher than what Medicare actually pays.
A markup ratio of 2.77x means for every $100 Medicare pays, this provider initially charges $277. 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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