This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Gynecological Oncology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 100% in 2020
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 | $596.15 | $134.16 | 4.44x | $461.99 | $273.9K | 4.6K | 2.0K |
| 2015 | $540.60 | $127.55 | 4.24x | $413.05 | $311.7K | 5.5K | 2.2K |
| 2016 | $443.56 | $107.50 | 4.13x | $336.06 | $395.6K | 7.2K | 2.7K |
| 2017 | $475.09 | $129.30 | 3.67x | $345.79 | $322.9K | 3.9K | 1.6K |
| 2018 | $368.63 | $77.42 | 4.76x | $291.21 | $180.9K | 2.9K | 1.4K |
| 2019 | $428.37 | $113.92 | 3.76x | $314.45 | $353.2K | 5.9K | 2.8K |
| 2020 | $396.92 | $76.31 | 5.20x | $320.61 | $705.2K | 11.9K | 5.6K |
| 2021 | $323.73 | $68.15 | 4.75x | $255.58 | $756.5K | 12.8K | 6.1K |
| 2022 | $225.01 | $46.86 | 4.80x | $178.15 | $335.3K | 9.1K | 4.7K |
| 2023 | $201.32 | $41.72 | 4.83x | $159.60 | $318.3K | 9.8K | 5.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 405 | $1.1M | $2.8K | 3.44x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.6K | $465.4K | $70.16 | 4.94x |
| G9678 | Oncology Care Model service | 2.5K | $400.4K | $158.13 | 1.89x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 3.2K | $306.1K | $95.44 | 5.88x |
| 58571 | Abdominal removal of uterus (250 grams or less) with removal of tubes and/or ovaries using an endoscope | 317 | $208.1K | $656.35 | 3.99x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.3K | $150.1K | $111.92 | 4.54x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 280 | $103.6K | $370.13 | 5.52x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 661 | $96.9K | $146.64 | 4.45x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.2K | $93.3K | $78.75 | 3.22x |
| 86304 | Immunologic analysis for detection of tumor antigen | 3.1K | $74.4K | $23.62 | 9.64x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.6K | $74.3K | $47.85 | 6.97x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 2.8K | $61.0K | $21.43 | 5.46x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.2K | $55.1K | $46.06 | 5.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 982 | $52.9K | $53.83 | 4.81x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 5.9K | $51.9K | $8.80 | 9.56x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 322 | $47.6K | $147.75 | 4.28x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 255 | $45.6K | $178.69 | 4.62x |
| 80048 | Blood test, basic group of blood chemicals | 4.6K | $35.7K | $7.79 | 9.73x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 623 | $33.5K | $53.85 | 4.59x |
| 80076 | Liver function blood test panel | 4.3K | $32.0K | $7.50 | 10.00x |
This provider submits charges 4.64 times higher than what Medicare actually pays.
A markup ratio of 4.64x means for every $100 Medicare pays, this provider initially charges $464. 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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