This provider's $4.3M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Their average markup ratio of 5.53x is significantly above the specialty median of 3.8x.
Medicare payments to this provider grew 72% from 2014 to 2023.
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 | $484.39 | $91.21 | 5.31x | $393.18 | $319.9K | 6.9K | 2.5K |
| 2015 | $479.47 | $90.92 | 5.27x | $388.55 | $347.0K | 7.9K | 2.8K |
| 2016 | $482.25 | $89.03 | 5.42x | $393.22 | $353.4K | 8.2K | 3.0K |
| 2017 | $497.01 | $87.49 | 5.68x | $409.52 | $350.0K | 8.4K | 3.3K |
| 2018 | $633.62 | $89.16 | 7.11x | $544.46 | $392.0K | 9.1K | 3.4K |
| 2019 | $761.47 | $121.54 | 6.27x | $639.93 | $423.1K | 9.5K | 3.6K |
| 2020 | $674.80 | $120.45 | 5.60x | $554.35 | $403.7K | 8.6K | 3.4K |
| 2021 | $554.87 | $105.98 | 5.24x | $448.89 | $556.5K | 10.8K | 4.0K |
| 2022 | $556.91 | $110.17 | 5.06x | $446.74 | $563.6K | 11.0K | 4.1K |
| 2023 | $596.88 | $99.80 | 5.98x | $497.08 | $549.9K | 11.4K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 25.7K | $1.7M | $67.20 | 4.96x |
| 76770 | Ultrasound behind abdominal cavity | 7.8K | $781.0K | $99.83 | 4.16x |
| 52214 | Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endoscope | 357 | $244.0K | $683.44 | 5.85x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $200.0K | $138.48 | 3.69x |
| 51720 | Bladder instillation of cancer preventive, inhibiting, or suppressive agent | 2.3K | $184.0K | $81.35 | 5.95x |
| 76857 | Ultrasound of pelvis | 3.8K | $160.0K | $41.81 | 6.47x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 247 | $152.4K | $617.02 | 5.67x |
| 81000 | Manual urinalysis test with examination using microscope | 30.3K | $123.0K | $4.06 | 9.34x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 9.2K | $118.8K | $12.94 | 17.43x |
| 76856 | Ultrasound of pelvis | 1.1K | $106.4K | $97.12 | 4.66x |
| 76872 | Ultrasound of rectum | 888 | $96.7K | $108.91 | 4.34x |
| 53661 | Dilation of bladder canal (urethra), female | 1.4K | $82.5K | $57.50 | 7.91x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 415 | $72.1K | $173.79 | 3.37x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 843 | $51.9K | $61.55 | 6.33x |
| 51702 | Insertion of indwelling bladder catheter | 799 | $45.0K | $56.29 | 8.94x |
| 51700 | Bladder irrigation and/or instillation | 495 | $33.9K | $68.47 | 6.96x |
| 76870 | Ultrasound of scrotum | 294 | $24.2K | $82.17 | 5.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 203 | $17.9K | $88.04 | 3.78x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 67 | $8.8K | $131.45 | 3.67x |
| 96402 | Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle | 213 | $6.3K | $29.61 | 7.26x |
This provider submits charges 5.53 times higher than what Medicare actually pays.
A markup ratio of 5.53x means for every $100 Medicare pays, this provider initially charges $553. 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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