This provider averages 63 services per working day
Based on 157.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Urology providers nationally.
Their average markup ratio of 5.6x is significantly above the specialty median of 3.8x.
Averaging 63 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 80% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 67% in 2023
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 | $744.45 | $98.70 | 7.54x | $645.75 | $514.4K | 15.6K | 9.8K |
| 2015 | $686.90 | $95.95 | 7.16x | $590.95 | $486.1K | 14.2K | 9.5K |
| 2016 | $680.75 | $87.42 | 7.79x | $593.33 | $430.2K | 11.9K | 8.2K |
| 2017 | $696.54 | $94.70 | 7.36x | $601.84 | $424.9K | 11.2K | 7.6K |
| 2018 | $647.61 | $89.61 | 7.23x | $558.00 | $397.8K | 10.4K | 7.1K |
| 2019 | $649.06 | $101.33 | 6.41x | $547.73 | $366.6K | 9.6K | 6.8K |
| 2020 | $536.83 | $76.47 | 7.02x | $460.36 | $322.9K | 9.0K | 6.4K |
| 2021 | $504.98 | $85.87 | 5.88x | $419.11 | $524.4K | 13.4K | 9.2K |
| 2022 | $379.81 | $64.41 | 5.90x | $315.40 | $554.6K | 21.6K | 16.3K |
| 2023 | $431.48 | $74.33 | 5.80x | $357.15 | $927.5K | 40.0K | 23.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 19.5K | $1.4M | $72.65 | 4.02x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 3.7K | $473.5K | $128.28 | 5.37x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $204.6K | $106.84 | 4.24x |
| 52356 | Crushing of stone in urinary duct (ureter) with stent using an endoscope | 605 | $192.7K | $318.46 | 8.11x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 19.3K | $183.8K | $9.51 | 15.29x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 3.1K | $137.9K | $43.89 | 2.16x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.3K | $127.9K | $54.80 | 3.24x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 195 | $114.4K | $586.92 | 5.52x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 680 | $111.7K | $164.28 | 2.19x |
| 52310 | Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope | 504 | $98.6K | $195.67 | 4.43x |
| 81007 | Urinalysis for bacteria | 3.3K | $97.9K | $29.36 | 1.53x |
| 51741 | Electronic assessment of bladder emptying | 9.6K | $91.9K | $9.52 | 25.54x |
| 52353 | Crushing of stone in urinary duct (ureter) using an endoscope | 239 | $68.7K | $287.60 | 11.40x |
| 74178 | CT scan of abdomen and pelvis before and after contrast | 393 | $67.1K | $170.68 | 9.43x |
| 84153 | PSA (prostate specific antigen) measurement | 3.0K | $66.2K | $21.76 | 5.24x |
| 74176 | CT scan of abdomen and pelvis | 904 | $65.8K | $72.77 | 17.80x |
| 76775 | Ultrasound behind abdominal cavity, limited | 1.7K | $65.8K | $38.62 | 7.40x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 911 | $63.6K | $69.81 | 4.61x |
| 52332 | Insertion of stent in urinary duct (ureter) using an endoscope | 480 | $55.1K | $114.73 | 10.62x |
| 81003 | Automated urinalysis test | 20.5K | $54.7K | $2.68 | 12.94x |
This provider submits charges 5.6 times higher than what Medicare actually pays.
A markup ratio of 5.6x means for every $100 Medicare pays, this provider initially charges $560. 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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