This provider's $6.2M in total Medicare payments ranks in the 99th percentile of Diagnostic Radiology providers nationally.
Their average markup ratio of 5.23x is significantly above the specialty median of 5.4x.
Medicare payments to this provider grew 2186% from 2014 to 2023.
62% of their billing comes from a single procedure code (77067 — Mammography of both breasts).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 665% 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 | $1.3K | $386.30 | 3.34x | $902.37 | $32.0K | 74 | 73 |
| 2015 | $2.3K | $508.72 | 4.43x | $1.7K | $17.3K | 34 | 34 |
| 2016 | $1.3K | $254.82 | 4.91x | $995.28 | $46.8K | 240 | 240 |
| 2017 | $1.2K | $227.96 | 5.19x | $955.08 | $54.5K | 332 | 331 |
| 2018 | $768.59 | $151.68 | 5.07x | $616.91 | $417.1K | 4.1K | 4.1K |
| 2019 | $531.89 | $95.56 | 5.57x | $436.33 | $1.2M | 13.5K | 13.4K |
| 2020 | $875.00 | $126.00 | 6.94x | $749.00 | $1.1M | 11.5K | 11.5K |
| 2021 | $677.12 | $95.63 | 7.08x | $581.49 | $1.3M | 15.0K | 15.0K |
| 2022 | $973.12 | $121.74 | 7.99x | $851.38 | $1.3M | 14.2K | 14.2K |
| 2023 | $1.0K | $115.20 | 8.85x | $904.60 | $731.3K | 8.5K | 8.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 77067 | Mammography of both breasts | 29.5K | $3.8M | $128.92 | 5.06x |
| 77063 | Screening digital tomography of both breasts | 29.5K | $1.6M | $53.02 | 4.84x |
| 19083 | Biopsy of breast accessed throught the skin with ultrasound guidance | 395 | $192.4K | $487.17 | 5.61x |
| 77066 | Mammography of both breasts | 915 | $102.2K | $111.72 | 7.18x |
| 19081 | Biopsy of breast accessed throught the skin with stereotactic guidance | 208 | $98.2K | $472.33 | 6.43x |
| 77065 | Mammography of one breast | 969 | $87.2K | $89.97 | 7.06x |
| 76642 | Ultrasound of one breast | 1.3K | $85.5K | $63.41 | 8.32x |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to g0204 or g0206) | 1.4K | $55.1K | $40.31 | 6.18x |
| 77080 | Bone density measurement using dedicated X-ray machine | 1.4K | $51.6K | $37.83 | 5.36x |
| 76641 | Ultrasound of one breast | 545 | $49.8K | $91.36 | 12.00x |
| G0202 | Screening mammography, producing direct digital image, bilateral, all views | 198 | $26.4K | $133.13 | 4.16x |
| 76700 | Ultrasound of abdomen | 172 | $12.8K | $74.67 | 7.11x |
| 76770 | Ultrasound behind abdominal cavity | 125 | $9.4K | $75.16 | 6.91x |
| 76377 | 3D radiographic procedure with computerized image postprocessing | 167 | $8.4K | $50.38 | 6.55x |
| 71046 | X-ray of chest, 2 views | 335 | $7.6K | $22.67 | 6.72x |
| 74177 | CT scan of abdomen and pelvis with contrast | 15 | $3.5K | $232.91 | 5.71x |
| 77049 | Mri scan of both breasts | 11 | $3.1K | $280.34 | 7.39x |
| 74176 | CT scan of abdomen and pelvis | 20 | $3.0K | $149.74 | 6.01x |
| 76536 | Ultrasound of head and neck | 38 | $3.0K | $78.78 | 6.42x |
| 71250 | CT scan chest | 12 | $1.5K | $123.48 | 6.90x |
This provider submits charges 5.23 times higher than what Medicare actually pays.
A markup ratio of 5.23x means for every $100 Medicare pays, this provider initially charges $523. 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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