This provider's $6.7M in total Medicare payments ranks in the 95th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.27x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 359% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 107% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $2.6K | $404.65 | 6.49x | $2.2K | $272.5K | 642 | 595 |
| 2016 | $4.5K | $646.35 | 7.01x | $3.9K | $565.1K | 1.1K | 963 |
| 2017 | $4.1K | $662.68 | 6.15x | $3.4K | $665.1K | 1.3K | 1.1K |
| 2018 | $3.8K | $607.40 | 6.32x | $3.2K | $624.3K | 1.2K | 1.1K |
| 2019 | $5.2K | $715.27 | 7.23x | $4.5K | $672.7K | 1.2K | 1.1K |
| 2020 | $5.2K | $694.38 | 7.44x | $4.5K | $633.2K | 1.1K | 1.0K |
| 2021 | $6.6K | $1.0K | 6.58x | $5.6K | $835.0K | 1.2K | 1.1K |
| 2022 | $9.0K | $1.8K | 5.15x | $7.3K | $1.2M | 1.3K | 1.1K |
| 2023 | $7.8K | $1.2K | 6.49x | $6.6K | $1.3M | 1.4K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 2.4K | $1.8M | $772.92 | 4.58x |
| 27447 | Repair of knee joint, lower or upper part of joint, inside and outside area | 84 | $586.8K | $7.0K | 5.72x |
| 45380 | Biopsy of large bowel using an endoscope | 1.3K | $437.7K | $348.22 | 7.52x |
| 29848 | Release of wrist ligament using an endoscope | 723 | $365.3K | $505.22 | 9.83x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 838 | $324.1K | $386.79 | 6.81x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 713 | $254.4K | $356.79 | 4.34x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 1.0K | $250.7K | $246.24 | 11.16x |
| 26055 | Incision of tendon covering | 598 | $248.7K | $415.90 | 7.72x |
| 63685 | Insertion of spinal neurostimulator generator or receiver | 12 | $226.6K | $18.9K | 2.73x |
| 66982 | Removal of cataract with insertion of lens | 288 | $216.3K | $751.04 | 5.07x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 105 | $203.7K | $1.9K | 10.03x |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 28 | $188.6K | $6.7K | 5.71x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 48 | $155.0K | $3.2K | 5.26x |
| 25447 | Removal of bone joints between wrist and fingers | 188 | $127.5K | $678.24 | 12.89x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 348 | $122.8K | $352.86 | 4.10x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 73 | $109.9K | $1.5K | 3.83x |
| 26480 | Transplant of tendon of hand | 107 | $102.1K | $954.66 | 6.86x |
| 55700 | Biopsy of prostate gland | 140 | $85.9K | $613.85 | 4.41x |
| 43249 | Balloon dilation of esophagus using an endoscope | 166 | $81.3K | $489.57 | 7.69x |
| 0191T | Internal insertion of eye fluid drainage device | 37 | $72.3K | $2.0K | 2.34x |
This provider submits charges 6.27 times higher than what Medicare actually pays.
A markup ratio of 6.27x means for every $100 Medicare pays, this provider initially charges $627. 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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