This provider's $6.5M 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.
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 | $354.90 | $124.99 | 2.84x | $229.91 | $808.1K | 15.2K | 8.0K |
| 2015 | $357.91 | $123.34 | 2.90x | $234.57 | $533.6K | 14.3K | 7.5K |
| 2016 | $413.49 | $115.03 | 3.59x | $298.46 | $418.8K | 9.6K | 6.3K |
| 2017 | $750.50 | $165.57 | 4.53x | $584.93 | $567.4K | 9.2K | 5.1K |
| 2018 | $685.84 | $165.68 | 4.14x | $520.16 | $599.7K | 10.5K | 5.1K |
| 2019 | $577.67 | $160.10 | 3.61x | $417.57 | $630.0K | 10.6K | 5.3K |
| 2020 | $496.00 | $147.12 | 3.37x | $348.88 | $641.7K | 10.9K | 5.0K |
| 2021 | $451.07 | $137.02 | 3.29x | $314.05 | $951.0K | 15.2K | 7.7K |
| 2022 | $462.23 | $138.76 | 3.33x | $323.47 | $776.7K | 14.5K | 7.1K |
| 2023 | $595.75 | $170.80 | 3.49x | $424.95 | $566.8K | 9.3K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J3490 | Unclassified drugs | 7.2K | $782.7K | $109.20 | 1.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.4K | $615.3K | $82.66 | 3.19x |
| 11980 | Insertion of hormone pellets beneath the skin | 7.3K | $516.3K | $70.82 | 3.15x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 4.3K | $496.2K | $115.98 | 2.93x |
| 52441 | Insertion of implant material in bladder using an endoscope | 300 | $311.2K | $1.0K | 2.41x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 1.9K | $300.3K | $154.97 | 3.67x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 531 | $282.2K | $531.50 | 4.01x |
| 52317 | Crushing, fragmenting, and removal of (less than 2.5 centimeters) bladder stone | 378 | $252.2K | $667.31 | 2.80x |
| 52214 | Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endoscope | 593 | $244.0K | $411.47 | 3.81x |
| 52442 | Insertion of implant material in bladder using an endoscope | 279 | $205.2K | $735.35 | 3.15x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 12.8K | $168.2K | $13.12 | 5.23x |
| 51728 | Insertion of electronic device into bladder with voiding pressure studies | 595 | $156.4K | $262.93 | 2.40x |
| 84403 | Testosterone (hormone) level | 3.7K | $126.5K | $34.29 | 2.07x |
| 64561 | Insertion of sacral nerve neurostimulator electrodes, accessed through the skin | 145 | $125.3K | $863.94 | 3.37x |
| 52001 | Irrigation and removal of multiple blood clots from bladder and bladder canal (urethra) using an endoscope | 670 | $115.7K | $172.65 | 5.07x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 11.2K | $115.6K | $10.32 | 4.65x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 153 | $100.5K | $657.01 | 2.71x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 793 | $93.4K | $117.84 | 3.72x |
| 51741 | Electronic assessment of bladder emptying | 10.3K | $88.0K | $8.56 | 21.37x |
| 76872 | Ultrasound of rectum | 988 | $86.9K | $87.90 | 3.59x |
This provider submits charges 3.44 times higher than what Medicare actually pays.
A markup ratio of 3.44x means for every $100 Medicare pays, this provider initially charges $344. 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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