This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Gastroenterology providers nationally.
Medicare payments to this provider grew 62% from 2014 to 2023.
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 | $295.57 | $100.86 | 2.93x | $194.71 | $344.7K | 5.1K | 2.8K |
| 2015 | $302.45 | $99.35 | 3.04x | $203.10 | $317.0K | 4.6K | 2.6K |
| 2016 | $307.54 | $95.39 | 3.22x | $212.15 | $328.7K | 4.2K | 2.7K |
| 2017 | $292.43 | $90.77 | 3.22x | $201.66 | $377.1K | 4.9K | 3.1K |
| 2018 | $299.33 | $91.93 | 3.26x | $207.40 | $433.6K | 5.9K | 3.7K |
| 2019 | $308.01 | $92.05 | 3.35x | $215.96 | $489.0K | 6.6K | 4.2K |
| 2020 | $308.99 | $95.70 | 3.23x | $213.29 | $431.6K | 5.7K | 3.5K |
| 2021 | $294.64 | $102.08 | 2.89x | $192.56 | $616.2K | 7.1K | 4.6K |
| 2022 | $328.18 | $99.07 | 3.31x | $229.11 | $624.9K | 7.4K | 5.0K |
| 2023 | $311.35 | $98.48 | 3.16x | $212.87 | $559.5K | 6.6K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 15.7K | $1.5M | $95.99 | 1.44x |
| 76700 | Ultrasound of abdomen | 6.9K | $744.4K | $108.31 | 2.31x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.9K | $733.8K | $67.33 | 1.56x |
| 76536 | Ultrasound of head and neck | 2.6K | $273.3K | $103.33 | 2.52x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $200.6K | $133.44 | 1.52x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 2.1K | $191.5K | $91.72 | 7.00x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 792 | $142.4K | $179.75 | 1.56x |
| 45380 | Biopsy of large bowel using an endoscope | 1.1K | $129.7K | $122.94 | 6.25x |
| 83013 | Breath test analysis for helicobacter pylori | 1.5K | $114.1K | $76.55 | 1.52x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.8K | $72.1K | $40.19 | 1.83x |
| 46930 | Destruction of internal anal hemorrhoids | 366 | $69.2K | $189.04 | 1.85x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 330 | $62.8K | $190.31 | 3.98x |
| G0008 | Administration of influenza virus vaccine | 2.0K | $49.3K | $24.53 | 1.32x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 299 | $45.3K | $151.58 | 4.24x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 255 | $41.1K | $161.06 | 6.04x |
| 90694 | Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, for injection into muscle, 0.5 ml dosage | 548 | $39.0K | $71.08 | 1.19x |
| 36415 | Insertion of needle into vein for collection of blood sample | 5.8K | $20.3K | $3.50 | 5.71x |
| 91200 | Measuring the stiffness in the liver via elastography | 568 | $17.2K | $30.35 | 3.13x |
| 45382 | Control of bleeding in upper large bowel using an endoscope | 63 | $13.9K | $220.62 | 1.96x |
| 83014 | Administration of drug for helicobacter pylori | 1.5K | $13.3K | $8.93 | 10.44x |
This provider submits charges 2.22 times higher than what Medicare actually pays.
A markup ratio of 2.22x means for every $100 Medicare pays, this provider initially charges $222. 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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