This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Urology providers nationally.
Medicare payments to this provider grew 497% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 127% in 2021
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 | $637.84 | $110.76 | 5.76x | $527.08 | $208.6K | 6.3K | 4.1K |
| 2015 | $718.42 | $110.49 | 6.50x | $607.93 | $186.5K | 5.2K | 3.6K |
| 2016 | $1.3K | $122.81 | 10.86x | $1.2K | $244.2K | 4.3K | 3.0K |
| 2017 | $1.3K | $120.32 | 10.60x | $1.2K | $299.4K | 5.5K | 3.7K |
| 2018 | $597.90 | $87.14 | 6.86x | $510.76 | $321.3K | 5.3K | 3.8K |
| 2019 | $578.76 | $105.15 | 5.50x | $473.61 | $407.2K | 6.3K | 4.6K |
| 2020 | $145.16 | $91.20 | 1.59x | $53.96 | $411.6K | 5.3K | 4.1K |
| 2021 | $316.73 | $120.25 | 2.63x | $196.48 | $935.0K | 12.3K | 8.4K |
| 2022 | $434.79 | $130.92 | 3.32x | $303.87 | $1.1M | 15.8K | 11.5K |
| 2023 | $431.37 | $129.25 | 3.34x | $302.12 | $1.2M | 17.5K | 12.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.1K | $984.0K | $107.71 | 2.65x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.3K | $605.1K | $140.55 | 3.53x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 1.7K | $443.2K | $256.95 | 2.67x |
| 52287 | Examination with injections of chemical for destruction of bladder using an endoscope | 1.2K | $394.8K | $325.46 | 3.83x |
| 51728 | Insertion of electronic device into bladder with voiding pressure studies | 1.2K | $368.3K | $313.97 | 2.95x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.8K | $366.9K | $62.77 | 4.35x |
| 76856 | Ultrasound of pelvis | 3.2K | $320.6K | $98.89 | 3.59x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 1.3K | $209.1K | $165.01 | 4.52x |
| 51797 | Insertion of device into the abdomen with measurement of pressure and urine flow rate | 1.2K | $178.2K | $147.39 | 2.64x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 540 | $168.9K | $312.69 | 2.62x |
| 76775 | Ultrasound behind abdominal cavity, limited | 2.5K | $136.6K | $55.16 | 2.50x |
| 57288 | Creation of sling around bladder canal (urethra) to control leakage | 166 | $105.6K | $636.23 | 5.87x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 5.9K | $86.5K | $14.73 | 5.08x |
| 87640 | Detection test for staphylococcus aureus (bacteria) | 2.2K | $74.7K | $34.73 | 2.19x |
| 87481 | Detection test for candida species (yeast) | 2.1K | $74.7K | $34.73 | 2.19x |
| 87653 | Detection test for strep (streptococcus, group b) | 2.1K | $74.7K | $34.73 | 2.19x |
| 87798 | Detection test for organism | 2.2K | $74.0K | $34.41 | 2.17x |
| 76770 | Ultrasound behind abdominal cavity | 684 | $70.7K | $103.33 | 11.60x |
| 87500 | Detection test for vancomycin resistance strep (vre) | 2.0K | $69.0K | $34.70 | 2.08x |
| 81002 | Urinalysis, manual test | 15.0K | $51.4K | $3.42 | 5.45x |
This provider submits charges 3.61 times higher than what Medicare actually pays.
A markup ratio of 3.61x means for every $100 Medicare pays, this provider initially charges $361. 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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