This provider's $3.2M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Medicare payments to this provider grew 566% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 668% in 2023
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 | $240.38 | $67.67 | 3.55x | $172.71 | $227.6K | 5.0K | 3.2K |
| 2015 | $247.32 | $68.51 | 3.61x | $178.81 | $209.9K | 4.4K | 2.7K |
| 2016 | $239.12 | $66.17 | 3.61x | $172.95 | $191.0K | 4.0K | 2.3K |
| 2017 | $238.40 | $65.80 | 3.62x | $172.60 | $215.5K | 4.7K | 2.8K |
| 2018 | $228.54 | $61.69 | 3.70x | $166.85 | $174.8K | 3.7K | 2.5K |
| 2019 | $234.70 | $62.68 | 3.74x | $172.02 | $120.9K | 2.0K | 1.2K |
| 2020 | $210.12 | $56.08 | 3.75x | $154.04 | $170.6K | 2.8K | 1.5K |
| 2021 | $216.39 | $62.88 | 3.44x | $153.51 | $223.7K | 3.7K | 1.8K |
| 2022 | $226.52 | $58.00 | 3.91x | $168.52 | $197.1K | 3.2K | 1.7K |
| 2023 | $3.5K | $1.4K | 2.50x | $2.1K | $1.5M | 4.1K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q2043 | Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion | 30 | $1.3M | $42.1K | 2.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.7K | $406.1K | $86.47 | 3.18x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.7K | $318.7K | $55.75 | 3.12x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 1.8K | $296.4K | $160.41 | 4.62x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.4K | $164.4K | $121.52 | 2.95x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 640 | $95.6K | $149.35 | 4.10x |
| 55700 | Biopsy of prostate gland | 350 | $69.6K | $198.78 | 4.21x |
| 96402 | Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle | 2.7K | $69.3K | $25.97 | 4.48x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 1.5K | $64.1K | $41.87 | 4.76x |
| 99487 | Complex chronic care management services 60 minutes clinical staff time | 423 | $43.6K | $102.96 | 5.13x |
| 76872 | Ultrasound of rectum | 365 | $39.0K | $106.82 | 3.77x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 370 | $36.2K | $97.80 | 3.09x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 263 | $31.1K | $118.44 | 2.92x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 842 | $30.9K | $36.68 | 5.25x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.0K | $30.5K | $15.65 | 5.09x |
| 51705 | Removal of skin suture with change of bladder tube | 424 | $29.2K | $68.80 | 4.28x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 402 | $28.6K | $71.12 | 4.10x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 1.6K | $23.4K | $14.24 | 4.74x |
| 99489 | Complex chronic care management services each additional 30 minutes clinical staff time | 408 | $22.0K | $53.90 | 5.10x |
| J0897 | Injection, denosumab, 1 mg | 1.4K | $21.4K | $14.82 | 4.09x |
This provider submits charges 3.23 times higher than what Medicare actually pays.
A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. 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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