This provider's $7.8M 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 | $1.2K | $265.13 | 4.71x | $983.04 | $693.6K | 2.5K | 2.4K |
| 2015 | $1.3K | $291.73 | 4.32x | $967.63 | $817.4K | 2.7K | 2.7K |
| 2016 | $1.3K | $307.81 | 4.09x | $951.55 | $864.2K | 2.9K | 2.8K |
| 2017 | $1.3K | $296.61 | 4.25x | $962.85 | $833.2K | 2.7K | 2.7K |
| 2018 | $1.3K | $302.24 | 4.17x | $957.12 | $792.5K | 2.5K | 2.5K |
| 2019 | $1.4K | $330.42 | 4.13x | $1.0K | $796.6K | 2.4K | 2.4K |
| 2020 | $1.3K | $309.51 | 4.13x | $968.31 | $652.3K | 2.0K | 2.0K |
| 2021 | $1.2K | $334.72 | 3.69x | $901.36 | $845.7K | 2.4K | 2.4K |
| 2022 | $1.4K | $354.98 | 3.83x | $1.0K | $782.6K | 2.3K | 2.3K |
| 2023 | $1.4K | $358.71 | 3.79x | $1.0K | $755.0K | 2.1K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 6.4K | $2.5M | $385.89 | 3.37x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 5.5K | $1.4M | $257.92 | 5.04x |
| 45380 | Biopsy of large bowel using an endoscope | 3.5K | $1.1M | $318.14 | 4.09x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 1.8K | $673.2K | $366.85 | 3.54x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 2.4K | $646.4K | $273.88 | 3.56x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 1.9K | $557.7K | $293.08 | 4.44x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 964 | $340.4K | $353.10 | 3.68x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 854 | $237.0K | $277.49 | 4.68x |
| 43249 | Balloon dilation of esophagus using an endoscope | 359 | $181.4K | $505.24 | 6.09x |
| 45331 | Biopsy of large bowel using an endoscope | 237 | $56.9K | $240.07 | 2.08x |
| 43450 | Dilation of esophagus | 159 | $43.7K | $274.62 | 3.55x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 82 | $40.2K | $490.50 | 2.65x |
| 45381 | Injections of large bowel using an endoscope | 123 | $25.5K | $207.11 | 6.28x |
| 45330 | Diagnostic examination of large bowel using an endoscope | 116 | $10.1K | $87.43 | 4.58x |
| 45338 | Placement of drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation | 11 | $4.4K | $395.99 | 1.64x |
This provider submits charges 3.99 times higher than what Medicare actually pays.
A markup ratio of 3.99x means for every $100 Medicare pays, this provider initially charges $399. 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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