This provider's $4.2M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Medicare payments to this provider grew 126% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 63% 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 | $565.41 | $152.64 | 3.70x | $412.77 | $234.2K | 3.6K | 2.0K |
| 2015 | $555.77 | $150.71 | 3.69x | $405.06 | $188.2K | 2.9K | 1.7K |
| 2016 | $543.36 | $153.81 | 3.53x | $389.55 | $210.2K | 2.9K | 1.8K |
| 2017 | $808.66 | $214.52 | 3.77x | $594.14 | $287.6K | 3.6K | 2.4K |
| 2018 | $704.33 | $178.40 | 3.95x | $525.93 | $295.8K | 3.8K | 2.7K |
| 2019 | $827.15 | $218.93 | 3.78x | $608.22 | $356.6K | 4.3K | 3.0K |
| 2020 | $523.88 | $163.40 | 3.21x | $360.48 | $580.4K | 9.9K | 6.1K |
| 2021 | $519.81 | $141.72 | 3.67x | $378.09 | $902.3K | 16.9K | 8.5K |
| 2022 | $421.03 | $127.69 | 3.30x | $293.34 | $654.0K | 13.1K | 7.4K |
| 2023 | $455.99 | $133.48 | 3.42x | $322.51 | $528.4K | 11.3K | 6.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.7K | $625.0K | $81.61 | 3.07x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 709 | $395.6K | $557.91 | 2.52x |
| 53850 | Destruction of prostate tissue through bladder canal (urethra) | 235 | $353.5K | $1.5K | 4.07x |
| 87801 | Detection test for multiple organisms | 3.8K | $266.2K | $69.59 | 2.51x |
| 51729 | Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies | 665 | $183.3K | $275.66 | 2.36x |
| 52441 | Insertion of implant material in bladder using an endoscope | 182 | $153.4K | $842.62 | 3.19x |
| 87641 | Detection test for staphylococcus aureus, methicillin resistant (mrsa bacteria) | 3.8K | $133.1K | $34.79 | 2.53x |
| 87640 | Detection test for staphylococcus aureus (bacteria) | 3.8K | $133.1K | $34.79 | 2.53x |
| 87798 | Detection test for organism | 3.8K | $133.1K | $34.79 | 2.53x |
| 87500 | Detection test for vancomycin resistance strep (vre) | 3.8K | $133.0K | $34.79 | 2.53x |
| 87651 | Detection test for strep (streptococcus, group a) | 3.8K | $133.0K | $34.79 | 2.53x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 975 | $110.6K | $113.44 | 3.15x |
| 52442 | Insertion of implant material in bladder using an endoscope | 182 | $107.9K | $592.79 | 3.15x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 765 | $106.9K | $139.69 | 3.78x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 3.0K | $103.1K | $34.75 | 2.53x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 3.0K | $102.9K | $34.74 | 2.53x |
| 76872 | Ultrasound of rectum | 902 | $82.1K | $90.98 | 3.80x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.4K | $77.0K | $56.21 | 2.99x |
| 51797 | Insertion of device into the abdomen with measurement of pressure and urine flow rate | 675 | $72.1K | $106.87 | 3.56x |
| 52648 | Laser vaporization of prostate including control of bleeding using an endoscope | 120 | $65.0K | $541.86 | 3.24x |
This provider submits charges 3.19 times higher than what Medicare actually pays.
A markup ratio of 3.19x means for every $100 Medicare pays, this provider initially charges $319. 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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