This provider's $18.8M in total Medicare payments ranks in the 98th 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 | $4.7K | $1.8K | 2.66x | $3.0K | $1.6M | 2.5K | 2.2K |
| 2015 | $4.9K | $1.7K | 2.97x | $3.3K | $1.3M | 2.4K | 2.0K |
| 2016 | $4.5K | $1.5K | 3.11x | $3.1K | $1.6M | 2.3K | 2.0K |
| 2017 | $5.7K | $1.9K | 3.01x | $3.8K | $1.6M | 2.2K | 2.0K |
| 2018 | $5.2K | $1.8K | 2.90x | $3.4K | $2.1M | 2.3K | 2.1K |
| 2019 | $6.4K | $1.8K | 3.68x | $4.7K | $2.0M | 2.4K | 2.1K |
| 2020 | $6.9K | $1.9K | 3.55x | $5.0K | $2.4M | 2.3K | 2.0K |
| 2021 | $7.2K | $2.1K | 3.44x | $5.1K | $2.2M | 2.3K | 2.0K |
| 2022 | $8.9K | $2.6K | 3.41x | $6.3K | $2.0M | 2.1K | 1.9K |
| 2023 | $9.1K | $2.3K | 4.02x | $6.8K | $2.0M | 1.9K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64590 | Insertion or replacement of peripheral or gastric neurostimulator generator | 276 | $3.6M | $13.0K | 2.91x |
| 54405 | Insertion of multi-component inflatable penile prosthesis | 252 | $2.7M | $10.7K | 2.80x |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 499 | $2.5M | $5.0K | 2.99x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 11.1K | $2.4M | $219.72 | 4.92x |
| 52356 | Crushing of stone in urinary duct (ureter) with stent using an endoscope | 707 | $1.0M | $1.5K | 5.24x |
| 55700 | Biopsy of prostate gland | 1.7K | $989.5K | $597.16 | 3.25x |
| 64581 | Incision to insert sacral nerve neurostimulator electrodes | 209 | $782.3K | $3.7K | 3.20x |
| 52310 | Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope | 928 | $553.3K | $596.27 | 3.61x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 376 | $552.5K | $1.5K | 3.23x |
| 52648 | Laser vaporization of prostate including control of bleeding using an endoscope | 370 | $516.9K | $1.4K | 3.89x |
| 50590 | Shock wave crushing of kidney stones | 410 | $474.9K | $1.2K | 4.90x |
| 64561 | Insertion of sacral nerve neurostimulator electrodes, accessed through the skin | 93 | $332.3K | $3.6K | 3.39x |
| 52332 | Insertion of stent in urinary duct (ureter) using an endoscope | 398 | $303.1K | $761.53 | 5.06x |
| 52235 | Destruction and/or removal of (2.0 to 5.0 centimeters) medium growths of the bladder and bladder canal (urethra) using an endoscope | 271 | $261.0K | $963.10 | 3.69x |
| 52234 | Destruction and/or removal of (0.5 to 2.0 centimeters) small growths of the bladder using an endoscope | 234 | $217.7K | $930.49 | 3.59x |
| 52204 | Biopsy of the bladder using an endoscope | 292 | $189.4K | $648.47 | 3.38x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 210 | $148.8K | $708.71 | 3.71x |
| 53445 | Insertion of inflatable urethra or bladder neck sphincter | 12 | $147.5K | $12.3K | 3.01x |
| 52287 | Examination with injections of chemical for destruction of bladder using an endoscope | 258 | $146.7K | $568.44 | 4.73x |
| 52351 | Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope | 167 | $126.7K | $758.91 | 5.30x |
This provider submits charges 3.58 times higher than what Medicare actually pays.
A markup ratio of 3.58x means for every $100 Medicare pays, this provider initially charges $358. 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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