This provider's $6.4M in total Medicare payments ranks in the 99th percentile of Urology providers nationally.
Their average markup ratio of 5.06x is significantly above the specialty median of 3.8x.
Medicare payments to this provider grew 71% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% in 2018
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 | $739.48 | $130.11 | 5.68x | $609.37 | $385.1K | 5.4K | 4.3K |
| 2015 | $661.72 | $117.31 | 5.64x | $544.41 | $436.0K | 6.5K | 5.1K |
| 2016 | $663.03 | $116.77 | 5.68x | $546.26 | $413.0K | 6.1K | 4.8K |
| 2017 | $686.93 | $122.36 | 5.61x | $564.57 | $448.2K | 6.3K | 5.1K |
| 2018 | $820.07 | $144.18 | 5.69x | $675.89 | $693.8K | 9.6K | 7.7K |
| 2019 | $985.25 | $150.40 | 6.55x | $834.85 | $852.0K | 11.1K | 8.0K |
| 2020 | $916.74 | $189.96 | 4.83x | $726.78 | $821.2K | 10.5K | 7.6K |
| 2021 | $881.33 | $182.56 | 4.83x | $698.77 | $855.8K | 11.3K | 7.9K |
| 2022 | $684.35 | $144.39 | 4.74x | $539.96 | $816.6K | 13.7K | 10.2K |
| 2023 | $689.35 | $138.61 | 4.97x | $550.74 | $657.0K | 12.0K | 9.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.9K | $1.2M | $89.54 | 4.10x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 5.0K | $815.3K | $161.93 | 4.48x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.0K | $447.5K | $63.56 | 4.08x |
| 76770 | Ultrasound behind abdominal cavity | 6.0K | $398.6K | $66.23 | 4.07x |
| 50590 | Shock wave crushing of kidney stones | 776 | $360.1K | $464.06 | 6.47x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.8K | $323.2K | $115.21 | 4.12x |
| 52648 | Laser vaporization of prostate including control of bleeding using an endoscope | 497 | $280.6K | $564.51 | 6.20x |
| 55874 | Injection of biodegradable material next to prostate | 115 | $259.7K | $2.3K | 3.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $201.3K | $120.44 | 4.35x |
| 51705 | Removal of skin suture with change of bladder tube | 1.8K | $133.1K | $73.73 | 4.07x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 11.2K | $127.2K | $11.38 | 7.97x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 3.2K | $118.7K | $37.54 | 1.75x |
| 76872 | Ultrasound of rectum | 1.5K | $112.3K | $76.74 | 5.30x |
| 52356 | Crushing of stone in urinary duct (ureter) with stent using an endoscope | 317 | $109.9K | $346.68 | 5.68x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 641 | $103.7K | $161.78 | 2.40x |
| 76775 | Ultrasound behind abdominal cavity, limited | 2.8K | $100.6K | $36.40 | 6.03x |
| 53855 | Insertion of a temporary bladder canal (urethra) stent, male, using an endoscope | 136 | $86.0K | $632.01 | 3.64x |
| 93976 | Ultrasound limited scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 886 | $77.1K | $87.06 | 6.98x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 100 | $64.6K | $646.22 | 3.57x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 570 | $61.5K | $107.94 | 3.44x |
This provider submits charges 5.06 times higher than what Medicare actually pays.
A markup ratio of 5.06x means for every $100 Medicare pays, this provider initially charges $506. 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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