This provider's $16.8M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 8.78x is significantly above the specialty median of 6.1x.
AI-generated analysis based on Medicare payment data.
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 | $4.5K | $1.2K | 3.76x | $3.3K | $1.5M | 2.8K | 2.7K |
| 2015 | $4.6K | $737.48 | 6.18x | $3.8K | $1.2M | 2.7K | 2.6K |
| 2016 | $5.5K | $780.24 | 7.00x | $4.7K | $1.3M | 2.9K | 2.8K |
| 2017 | $6.4K | $1.1K | 5.66x | $5.3K | $1.7M | 3.0K | 2.9K |
| 2018 | $6.3K | $1.2K | 5.44x | $5.1K | $1.8M | 3.0K | 2.9K |
| 2019 | $7.1K | $1.4K | 4.96x | $5.7K | $1.9M | 2.8K | 2.8K |
| 2020 | $7.9K | $1.7K | 4.64x | $6.2K | $1.5M | 2.1K | 2.1K |
| 2021 | $7.6K | $1.5K | 5.06x | $6.1K | $2.0M | 2.8K | 2.8K |
| 2022 | $7.8K | $1.6K | 4.92x | $6.2K | $2.0M | 2.7K | 2.7K |
| 2023 | $7.2K | $1.3K | 5.51x | $5.9K | $1.9M | 3.2K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 7.6K | $3.0M | $398.17 | 12.44x |
| 63685 | Insertion of spinal neurostimulator pulse generator or receiver | 94 | $1.7M | $18.2K | 1.95x |
| 45380 | Biopsy of large bowel using an endoscope | 3.9K | $1.2M | $321.32 | 15.24x |
| 43249 | Balloon dilation of esophagus using an endoscope | 1.6K | $797.6K | $513.23 | 9.31x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 3.1K | $765.9K | $249.49 | 19.19x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 248 | $754.3K | $3.0K | 3.08x |
| 62362 | Implantation or replacement of programmable spinal canal drug infusion pump | 69 | $720.4K | $10.4K | 2.15x |
| 64590 | Insertion or replacement of peripheral or gastric neurostimulator generator | 48 | $663.7K | $13.8K | 2.27x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 175 | $625.5K | $3.6K | 2.92x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 1.4K | $550.2K | $379.96 | 10.26x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 1.4K | $537.0K | $384.68 | 10.28x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 234 | $498.0K | $2.1K | 4.96x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 666 | $335.1K | $503.14 | 18.61x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 1.1K | $295.9K | $277.54 | 14.07x |
| 58558 | Biopsy and/or removal of polyp of the uterus using an endoscope | 299 | $280.1K | $936.81 | 9.28x |
| 29881 | Removal of one knee cartilage using an endoscope | 224 | $229.3K | $1.0K | 5.85x |
| 64721 | Release and/or relocation of median nerve of hand | 449 | $226.9K | $505.45 | 8.70x |
| 52356 | Crushing of stone in urinary duct (ureter) with stent using an endoscope | 140 | $218.8K | $1.6K | 3.26x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 250 | $192.4K | $769.71 | 7.64x |
| 25447 | Removal of bone joints between wrist and fingers | 177 | $178.3K | $1.0K | 6.35x |
This provider submits charges 8.78 times higher than what Medicare actually pays.
A markup ratio of 8.78x means for every $100 Medicare pays, this provider initially charges $878. 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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