This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Urology 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 70% in 2021
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 | $1.6K | $190.35 | 8.15x | $1.4K | $394.2K | 5.0K | 3.6K |
| 2015 | $1.6K | $191.54 | 8.16x | $1.4K | $410.4K | 5.2K | 3.6K |
| 2016 | $1.5K | $150.54 | 10.02x | $1.4K | $372.3K | 4.2K | 3.2K |
| 2017 | $1.4K | $170.22 | 8.47x | $1.3K | $446.8K | 4.9K | 4.0K |
| 2018 | $1.2K | $158.77 | 7.32x | $1.0K | $437.7K | 5.3K | 4.2K |
| 2019 | $362.25 | $101.24 | 3.58x | $261.01 | $411.8K | 5.9K | 4.3K |
| 2020 | $1.1K | $151.21 | 7.17x | $932.96 | $413.9K | 5.1K | 3.8K |
| 2021 | $263.76 | $79.80 | 3.31x | $183.96 | $703.2K | 13.3K | 9.4K |
| 2022 | $849.76 | $146.14 | 5.81x | $703.62 | $623.5K | 9.8K | 7.4K |
| 2023 | $669.68 | $130.89 | 5.12x | $538.79 | $535.8K | 6.3K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.6K | $649.6K | $61.36 | 3.58x |
| 76770 | Ultrasound behind abdominal cavity | 5.6K | $517.9K | $92.43 | 5.94x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 2.1K | $345.4K | $166.45 | 2.93x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.6K | $339.9K | $93.62 | 3.42x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.2K | $286.4K | $130.72 | 3.16x |
| 51728 | Insertion of electronic device into bladder with voiding pressure studies | 838 | $234.2K | $279.43 | 2.49x |
| 76775 | Ultrasound behind abdominal cavity, limited | 4.8K | $231.7K | $48.76 | 4.11x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 689 | $162.1K | $235.32 | 2.20x |
| 55866 | Surgical removal of prostate and surrounding lymph nodes using an endoscope | 139 | $161.5K | $1.2K | 12.46x |
| 76872 | Ultrasound of rectum | 1.4K | $143.9K | $100.19 | 5.77x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 1.7K | $122.5K | $70.09 | 2.14x |
| 51797 | Insertion of device into the abdomen with measurement of pressure and urine flow rate | 906 | $100.3K | $110.68 | 5.52x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.3K | $92.4K | $40.80 | 3.70x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 137 | $86.9K | $633.95 | 2.83x |
| 55700 | Biopsy of prostate gland | 341 | $65.5K | $192.03 | 3.01x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 382 | $64.4K | $168.58 | 4.14x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 1.7K | $61.2K | $35.04 | 2.85x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 1.7K | $61.2K | $35.04 | 2.85x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 1.7K | $61.2K | $35.04 | 2.85x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 1.7K | $61.2K | $35.04 | 2.85x |
This provider submits charges 4.76 times higher than what Medicare actually pays.
A markup ratio of 4.76x means for every $100 Medicare pays, this provider initially charges $476. 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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