This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Surgical Oncology providers nationally.
Medicare payments to this provider grew 187% 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 | $565.74 | $156.38 | 3.62x | $409.36 | $242.2K | 2.5K | 2.2K |
| 2015 | $923.85 | $222.64 | 4.15x | $701.21 | $359.2K | 3.5K | 2.9K |
| 2016 | $1.2K | $266.36 | 4.44x | $915.95 | $413.1K | 4.2K | 3.3K |
| 2017 | $1.5K | $287.97 | 5.21x | $1.2K | $493.1K | 4.0K | 3.3K |
| 2018 | $1.3K | $248.39 | 5.07x | $1.0K | $582.2K | 4.4K | 3.8K |
| 2019 | $439.61 | $121.63 | 3.61x | $317.98 | $583.9K | 5.1K | 4.4K |
| 2020 | $783.07 | $143.53 | 5.46x | $639.54 | $520.0K | 5.1K | 4.5K |
| 2021 | $942.03 | $205.63 | 4.58x | $736.40 | $686.0K | 5.9K | 5.0K |
| 2022 | $1.1K | $226.44 | 4.89x | $880.48 | $670.8K | 6.1K | 5.1K |
| 2023 | $1.1K | $206.23 | 5.15x | $856.27 | $694.7K | 6.7K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 76641 | Ultrasound of one breast | 11.3K | $1.5M | $129.39 | 2.70x |
| 77066 | Mammography of both breasts | 7.9K | $1.1M | $139.98 | 1.61x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.9K | $842.1K | $85.03 | 2.53x |
| 19083 | Biopsy of breast accessed throught the skin with ultrasound guidance | 563 | $306.8K | $545.00 | 4.57x |
| 77056 | Mammography of both breasts | 3.0K | $295.3K | $98.41 | 2.29x |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 6.1K | $291.4K | $47.76 | 6.28x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.8K | $255.8K | $66.73 | 3.37x |
| G0204 | Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral | 1.2K | $176.4K | $145.93 | 1.54x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 860 | $112.2K | $130.50 | 2.68x |
| 19302 | Partial removal of breast and underarm lymph nodes | 108 | $92.1K | $853.08 | 5.28x |
| 19301 | Partial removal of breast | 126 | $72.4K | $574.63 | 8.77x |
| 77065 | Mammography of one breast | 647 | $70.6K | $109.07 | 1.38x |
| 76645 | Ultrasound of breasts | 636 | $56.1K | $88.16 | 5.32x |
| 76642 | Ultrasound of one breast | 247 | $22.4K | $90.73 | 2.21x |
| 77055 | Mammography of one breast | 268 | $19.8K | $73.83 | 2.08x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 217 | $10.4K | $47.79 | 4.71x |
| 77067 | Mammography of both breasts | 65 | $9.7K | $148.52 | 2.02x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 85 | $8.9K | $104.25 | 2.85x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 179 | $7.9K | $43.94 | 6.83x |
| 77063 | Screening digital tomography of both breasts | 65 | $3.8K | $59.22 | 3.82x |
This provider submits charges 2.87 times higher than what Medicare actually pays.
A markup ratio of 2.87x means for every $100 Medicare pays, this provider initially charges $287. 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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