This provider's $7.6M in total Medicare payments ranks in the 96th percentile of Ambulatory Surgical Center providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $1.0K | $267.71 | 3.86x | $765.24 | $724.5K | 2.6K | 2.6K |
| 2015 | $1.1K | $275.91 | 3.82x | $778.57 | $758.6K | 2.6K | 2.6K |
| 2016 | $1.1K | $297.21 | 3.63x | $780.80 | $832.9K | 2.7K | 2.6K |
| 2017 | $1.3K | $289.90 | 4.33x | $965.66 | $792.9K | 2.8K | 2.7K |
| 2018 | $1.3K | $297.52 | 4.22x | $958.04 | $782.0K | 2.6K | 2.6K |
| 2019 | $1.3K | $308.90 | 4.06x | $946.66 | $812.2K | 2.6K | 2.6K |
| 2020 | $1.3K | $312.57 | 4.01x | $942.38 | $615.3K | 2.0K | 1.9K |
| 2021 | $1.3K | $330.57 | 3.80x | $924.99 | $761.9K | 2.3K | 2.3K |
| 2022 | $1.3K | $332.63 | 3.77x | $922.38 | $757.4K | 2.3K | 2.2K |
| 2023 | $1.2K | $341.66 | 3.66x | $908.13 | $771.4K | 2.2K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 5.9K | $2.1M | $348.76 | 3.57x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 4.1K | $1.0M | $245.95 | 4.21x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 2.8K | $983.7K | $346.14 | 3.55x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 2.7K | $910.4K | $337.81 | 3.63x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 3.0K | $829.3K | $274.23 | 4.47x |
| 45380 | Biopsy of large bowel using an endoscope | 2.4K | $792.2K | $326.96 | 3.78x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 2.4K | $634.3K | $263.64 | 4.57x |
| 43450 | Dilation of esophagus | 983 | $280.5K | $285.40 | 3.76x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 248 | $86.8K | $349.80 | 3.72x |
| 45381 | Injections of large bowel using an endoscope | 39 | $8.3K | $211.68 | 5.20x |
This provider submits charges 3.87 times higher than what Medicare actually pays.
A markup ratio of 3.87x means for every $100 Medicare pays, this provider initially charges $387. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Main Line Surgery Center, Llc | Bala Cynwyd, PA | $38.7M | ✓ Clear |
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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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