This provider's $8.3M 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 | $1.3K | $249.62 | 5.08x | $1.0K | $760.4K | 2.6K | 2.6K |
| 2015 | $1.3K | $278.48 | 4.61x | $1.0K | $770.7K | 2.5K | 2.5K |
| 2016 | $1.3K | $303.13 | 4.30x | $1.0K | $843.6K | 2.6K | 2.6K |
| 2017 | $1.3K | $284.76 | 4.70x | $1.1K | $834.3K | 2.6K | 2.6K |
| 2018 | $1.3K | $316.76 | 4.25x | $1.0K | $951.1K | 2.8K | 2.7K |
| 2019 | $1.3K | $315.80 | 4.23x | $1.0K | $994.1K | 2.8K | 2.8K |
| 2020 | $1.3K | $318.07 | 4.20x | $1.0K | $714.9K | 2.0K | 2.0K |
| 2021 | $1.4K | $351.04 | 3.87x | $1.0K | $866.6K | 2.3K | 2.3K |
| 2022 | $1.4K | $346.82 | 3.96x | $1.0K | $746.7K | 2.0K | 2.0K |
| 2023 | $1.4K | $364.27 | 3.77x | $1.0K | $795.7K | 2.0K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 6.0K | $2.4M | $394.82 | 3.63x |
| 45380 | Biopsy of large bowel using an endoscope | 4.5K | $1.5M | $325.74 | 4.35x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 2.6K | $960.0K | $372.10 | 3.74x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 3.4K | $918.4K | $267.98 | 5.23x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 2.1K | $775.7K | $370.78 | 3.75x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 2.7K | $733.8K | $271.68 | 4.29x |
| 43249 | Balloon dilation of esophagus using an endoscope | 930 | $476.9K | $512.77 | 2.75x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.3K | $368.5K | $279.98 | 5.01x |
| 43450 | Dilation of esophagus | 312 | $82.4K | $264.22 | 4.26x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 215 | $62.5K | $290.70 | 4.75x |
| 45381 | Injections of large bowel using an endoscope | 145 | $33.9K | $233.93 | 6.08x |
| 45331 | Biopsy of large bowel using an endoscope | 65 | $17.1K | $262.45 | 4.32x |
| 45330 | Diagnostic examination of large bowel using an endoscope | 108 | $9.2K | $85.62 | 12.75x |
| 46221 | Removal of hemorrhoid by rubber banding | 12 | $1.4K | $116.11 | 8.78x |
This provider submits charges 4.07 times higher than what Medicare actually pays.
A markup ratio of 4.07x means for every $100 Medicare pays, this provider initially charges $407. 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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