This provider averages 59 services per working day
Based on 148.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.1M in total Medicare payments ranks in the 99th percentile of Gastroenterology providers nationally.
Averaging 59 services per working day raises questions about billing patterns.
63% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
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 | $506.03 | $96.25 | 5.26x | $409.78 | $641.5K | 10.3K | 1.2K |
| 2015 | $476.75 | $94.76 | 5.03x | $381.99 | $573.6K | 10.9K | 1.8K |
| 2016 | $387.62 | $83.67 | 4.63x | $303.95 | $765.7K | 14.7K | 2.0K |
| 2017 | $506.85 | $90.06 | 5.63x | $416.79 | $832.8K | 16.4K | 1.8K |
| 2018 | $386.71 | $81.56 | 4.74x | $305.15 | $877.3K | 17.3K | 1.6K |
| 2019 | $502.42 | $91.84 | 5.47x | $410.58 | $948.6K | 18.3K | 1.6K |
| 2020 | $459.92 | $84.60 | 5.44x | $375.32 | $1.0M | 18.5K | 1.5K |
| 2021 | $420.02 | $81.87 | 5.13x | $338.15 | $803.6K | 15.2K | 1.2K |
| 2022 | $460.99 | $82.69 | 5.57x | $378.30 | $799.0K | 14.1K | 1.2K |
| 2023 | $411.20 | $80.16 | 5.13x | $331.04 | $818.7K | 12.5K | 1.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 82.2K | $5.1M | $61.52 | 1.74x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 49.6K | $1.6M | $33.03 | 3.03x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 5.4K | $618.9K | $114.10 | 1.88x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 4.3K | $212.9K | $49.44 | 1.52x |
| 43246 | Insertion of stomach tube using an endoscope | 1.0K | $173.6K | $172.22 | 8.11x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.7K | $148.3K | $85.99 | 1.42x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.3K | $85.5K | $36.47 | 3.29x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 538 | $64.1K | $119.22 | 10.08x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 376 | $14.5K | $38.60 | 1.94x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 180 | $13.4K | $74.22 | 2.00x |
| 45380 | Biopsy of large bowel using an endoscope | 61 | $11.8K | $193.81 | 8.24x |
| 93307 | Chest ultrasound examination of heart | 104 | $9.8K | $94.12 | 1.27x |
| 99318 | Nursing facility annual assessment, typically 30 minutes | 113 | $9.0K | $79.75 | 2.01x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 97 | $5.8K | $60.25 | 1.25x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 36 | $2.4K | $66.00 | 1.28x |
This provider submits charges 2.23 times higher than what Medicare actually pays.
A markup ratio of 2.23x means for every $100 Medicare pays, this provider initially charges $223. 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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