This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 320% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 79% in 2021
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 | $233.28 | $106.89 | 2.18x | $126.39 | $230.7K | 2.3K | 2.0K |
| 2015 | $275.41 | $123.08 | 2.24x | $152.33 | $325.4K | 2.2K | 1.9K |
| 2016 | $307.39 | $118.25 | 2.60x | $189.14 | $342.7K | 2.4K | 2.2K |
| 2017 | $317.32 | $151.09 | 2.10x | $166.23 | $412.6K | 2.4K | 2.2K |
| 2018 | $273.85 | $94.77 | 2.89x | $179.08 | $328.7K | 2.7K | 2.4K |
| 2019 | $265.93 | $97.53 | 2.73x | $168.40 | $356.8K | 3.1K | 2.9K |
| 2020 | $314.13 | $84.88 | 3.70x | $229.25 | $278.2K | 2.9K | 2.6K |
| 2021 | $335.79 | $68.61 | 4.89x | $267.18 | $497.0K | 7.3K | 6.7K |
| 2022 | $355.43 | $75.30 | 4.72x | $280.13 | $623.6K | 8.6K | 8.1K |
| 2023 | $323.32 | $105.14 | 3.08x | $218.18 | $968.9K | 11.3K | 10.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens | 6.1K | $1.9M | $317.91 | 2.75x |
| 88112 | Cell examination of specimen | 14.2K | $738.0K | $51.90 | 2.50x |
| 88342 | Tissue or cell analysis by immunologic technique | 7.6K | $467.5K | $61.91 | 3.30x |
| 88344 | Special stained specimen slides to examine tissue | 3.5K | $384.3K | $109.02 | 2.62x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 3.7K | $227.6K | $61.00 | 1.97x |
| 88120 | Cell examination of urine | 1.1K | $159.3K | $140.61 | 5.69x |
| 88341 | Special stained specimen slides to examine tissue | 3.5K | $144.9K | $41.83 | 3.08x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 2.0K | $99.9K | $49.27 | 2.84x |
| 88360 | Microscopic genetic analysis of tumor | 856 | $57.9K | $67.68 | 2.77x |
| 88377 | Microscopic genetic examination manual | 792 | $47.5K | $60.00 | 6.99x |
| 88366 | Cell examination | 539 | $29.5K | $54.68 | 3.03x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 222 | $15.0K | $67.55 | 1.63x |
| 88367 | Microscopic genetic analysis of tissue | 250 | $14.3K | $57.03 | 6.07x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 216 | $11.4K | $52.94 | 1.80x |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 48 | $10.5K | $217.86 | 1.48x |
| 88121 | Cell examination of urine | 191 | $7.1K | $37.07 | 17.94x |
| 88300 | Pathology examination of tissue using a microscope, limited examination | 271 | $3.2K | $11.83 | 3.80x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 28 | $2.0K | $71.09 | 2.63x |
This provider submits charges 2.91 times higher than what Medicare actually pays.
A markup ratio of 2.91x means for every $100 Medicare pays, this provider initially charges $291. 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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