This provider's $14.3M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 145% in 2015
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 | $1.0K | $315.12 | 3.32x | $730.56 | $527.5K | 4.6K | 4.5K |
| 2015 | $1.1K | $291.40 | 3.94x | $856.74 | $1.3M | 7.5K | 7.1K |
| 2016 | $1.2K | $290.21 | 4.05x | $884.43 | $1.2M | 8.2K | 7.6K |
| 2017 | $1.2K | $277.52 | 4.17x | $880.25 | $1.5M | 8.7K | 8.0K |
| 2018 | $1.1K | $244.28 | 4.31x | $809.46 | $1.3M | 8.4K | 7.7K |
| 2019 | $1.0K | $217.52 | 4.67x | $797.82 | $1.9M | 10.3K | 9.2K |
| 2020 | $1.2K | $241.59 | 4.79x | $916.08 | $1.8M | 9.0K | 7.9K |
| 2021 | $968.52 | $256.07 | 3.78x | $712.45 | $2.1M | 10.4K | 9.0K |
| 2022 | $961.43 | $253.46 | 3.79x | $707.97 | $2.2M | 11.0K | 9.5K |
| 2023 | $587.21 | $119.72 | 4.90x | $467.49 | $481.5K | 4.1K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88120 | Cell examination of urine | 11.4K | $6.8M | $597.17 | 3.84x |
| 88112 | Cell examination of specimen | 55.5K | $3.4M | $60.42 | 3.96x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens | 6.1K | $2.5M | $416.54 | 4.97x |
| 88344 | Special stained specimen slides to examine tissue | 4.9K | $807.9K | $164.84 | 3.59x |
| 88121 | Cell examination of urine | 1.3K | $603.7K | $465.48 | 4.02x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1.4K | $77.0K | $55.45 | 4.43x |
| 88342 | Tissue or cell analysis by immunologic technique | 1.2K | $76.7K | $62.72 | 4.86x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 447 | $36.6K | $81.78 | 3.83x |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 77 | $5.6K | $73.17 | 5.64x |
| 88341 | Special stained specimen slides to examine tissue | 28 | $1.6K | $58.26 | 3.87x |
This provider submits charges 4.07 times higher than what Medicare actually pays.
A markup ratio of 4.07x means for every $100 Medicare pays, this provider initially charges $407. 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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