This provider's $4.0M in total Medicare payments ranks in the 92th percentile of Ambulatory Surgical Center providers nationally.
Medicare payments to this provider grew 341% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 181% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $883.47 | $295.60 | 2.99x | $587.87 | $245.4K | 896 | 878 |
| 2020 | $1.3K | $505.20 | 2.63x | $822.80 | $689.9K | 2.4K | 2.1K |
| 2021 | $1.1K | $321.07 | 3.32x | $746.31 | $857.5K | 3.2K | 2.7K |
| 2022 | $1.7K | $520.58 | 3.23x | $1.2K | $1.1M | 3.4K | 2.9K |
| 2023 | $1.9K | $435.12 | 4.46x | $1.5K | $1.1M | 3.4K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 55700 | Biopsy of prostate gland | 1.6K | $1.0M | $616.65 | 2.60x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 3.9K | $824.8K | $212.57 | 3.54x |
| 45380 | Biopsy of large bowel using an endoscope | 640 | $220.2K | $344.00 | 3.39x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 654 | $177.0K | $270.61 | 3.16x |
| 52315 | Complicated removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope | 274 | $168.3K | $614.33 | 2.80x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 275 | $161.8K | $588.47 | 2.49x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 367 | $153.3K | $417.74 | 2.96x |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 27 | $147.0K | $5.4K | 2.33x |
| 52310 | Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope | 167 | $101.5K | $607.97 | 3.01x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 395 | $95.6K | $241.95 | 4.11x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 165 | $87.9K | $532.50 | 2.75x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 320 | $78.0K | $243.81 | 3.48x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 177 | $65.9K | $372.43 | 2.47x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 167 | $64.8K | $388.18 | 2.46x |
| 76872 | Ultrasound of rectum | 1.5K | $64.3K | $41.88 | 27.22x |
| 64721 | Release and/or relocation of median nerve of hand | 92 | $53.5K | $581.17 | 2.38x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 209 | $51.8K | $248.04 | 3.39x |
| 52234 | Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm | 40 | $45.0K | $1.1K | 3.14x |
| 55706 | Needle biopsy of prostate gland using image guidance | 30 | $31.8K | $1.1K | 2.21x |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 149 | $31.6K | $211.90 | 4.15x |
This provider submits charges 3.65 times higher than what Medicare actually pays.
A markup ratio of 3.65x means for every $100 Medicare pays, this provider initially charges $365. 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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