This provider's $3.6M in total Medicare payments ranks in the 91th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7x 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 | $1.8K | $242.76 | 7.42x | $1.6K | $363.0K | 1.5K | 1.4K |
| 2015 | $1.8K | $251.74 | 7.23x | $1.6K | $311.3K | 1.2K | 1.1K |
| 2016 | $1.8K | $272.48 | 6.78x | $1.6K | $376.5K | 1.3K | 1.2K |
| 2017 | $1.8K | $239.68 | 7.61x | $1.6K | $341.0K | 1.4K | 1.3K |
| 2018 | $1.8K | $242.60 | 7.50x | $1.6K | $341.4K | 1.4K | 1.3K |
| 2019 | $1.8K | $269.09 | 6.81x | $1.6K | $390.7K | 1.5K | 1.4K |
| 2020 | $1.8K | $272.94 | 6.71x | $1.6K | $334.2K | 1.2K | 1.2K |
| 2021 | $1.8K | $264.68 | 6.86x | $1.6K | $318.3K | 1.2K | 1.1K |
| 2022 | $1.8K | $268.59 | 6.78x | $1.6K | $401.1K | 1.4K | 1.3K |
| 2023 | $1.7K | $291.44 | 5.84x | $1.4K | $375.9K | 1.3K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 2.6K | $615.9K | $235.60 | 8.48x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 1.8K | $566.4K | $308.35 | 6.49x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 2.2K | $560.8K | $258.90 | 7.76x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 1.1K | $394.4K | $371.73 | 5.40x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 1.4K | $352.1K | $256.85 | 5.84x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 1.3K | $346.9K | $268.52 | 7.45x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 1.1K | $332.0K | $315.56 | 6.32x |
| 45380 | Biopsy of large bowel using an endoscope | 574 | $183.4K | $319.44 | 6.29x |
| 46221 | Removal of hemorrhoid by rubber banding | 1.2K | $151.2K | $130.67 | 7.85x |
| 45331 | Biopsy of large bowel using an endoscope | 148 | $34.8K | $235.38 | 7.30x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare | 16 | $9.0K | $563.14 | 3.55x |
| 45330 | Diagnostic examination of large bowel using an endoscope | 70 | $6.0K | $85.38 | 20.50x |
| 76705 | Limited ultrasound scan of abdomen | 15 | $615.00 | $41.00 | 3.05x |
This provider submits charges 7 times higher than what Medicare actually pays.
A markup ratio of 7x means for every $100 Medicare pays, this provider initially charges $700. 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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