This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Colorectal Surgery (Proctology) providers nationally.
Medicare payments to this provider grew 286% from 2014 to 2023.
78% of their billing comes from a single procedure code (45388 — Destruction of large bowel growths using an endoscope).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 230% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $355.13 | $169.40 | 2.10x | $185.73 | $151.8K | 804 | 671 |
| 2015 | $634.25 | $184.57 | 3.44x | $449.68 | $149.2K | 1.1K | 799 |
| 2016 | $1.1K | $474.76 | 2.25x | $591.66 | $493.1K | 1.1K | 838 |
| 2017 | $997.53 | $442.32 | 2.26x | $555.21 | $582.8K | 1.3K | 938 |
| 2018 | $995.56 | $473.33 | 2.10x | $522.23 | $637.3K | 1.4K | 918 |
| 2019 | $1.2K | $521.24 | 2.23x | $641.55 | $545.6K | 1.1K | 822 |
| 2020 | $904.18 | $413.36 | 2.19x | $490.82 | $458.6K | 1.2K | 878 |
| 2021 | $816.47 | $396.46 | 2.06x | $420.01 | $762.5K | 1.7K | 1.2K |
| 2022 | $893.69 | $346.34 | 2.58x | $547.35 | $621.2K | 1.5K | 1.1K |
| 2023 | $897.07 | $397.74 | 2.26x | $499.33 | $586.7K | 1.4K | 997 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45388 | Destruction of large bowel growths using an endoscope | 1.4K | $3.9M | $2.8K | 1.92x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.9K | $422.4K | $71.62 | 2.32x |
| 46500 | Injection of hemorrhoids | 766 | $190.0K | $248.00 | 1.61x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 626 | $103.5K | $165.37 | 4.98x |
| 45383 | Removal of polyps or growths in large bowel using an endoscope | 143 | $72.9K | $509.48 | 1.49x |
| G6024 | Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare tehnique | 134 | $67.2K | $501.84 | 3.62x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 593 | $58.0K | $97.88 | 2.21x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 455 | $54.4K | $119.60 | 7.63x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 163 | $53.9K | $330.67 | 1.82x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 56 | $23.4K | $417.47 | 1.61x |
| 12021 | Repair of separation of wound closure with insertion of packing | 146 | $19.0K | $129.83 | 2.28x |
| 87635 | Sars-cov-2 covid-19 amp prb | 295 | $15.1K | $51.29 | 1.74x |
| 93041 | Tracing of electrical activity of the heart using 1-3 leads | 1.7K | $9.9K | $5.81 | 12.89x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 49 | $6.0K | $121.63 | 1.95x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 100 | $2.3K | $23.39 | 2.53x |
| 46600 | Diagnostic exam of anus using an endoscope | 16 | $1.9K | $116.55 | 1.32x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 21 | $744.61 | $35.46 | 1.70x |
| 85610 | Blood test, clotting time | 16 | $84.16 | $5.26 | 4.75x |
This provider submits charges 2.11 times higher than what Medicare actually pays.
A markup ratio of 2.11x means for every $100 Medicare pays, this provider initially charges $211. 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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