This provider's $7.2M 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 | $274.68 | $127.10 | 2.16x | $147.58 | $641.2K | 12.3K | 8.1K |
| 2015 | $334.09 | $119.78 | 2.79x | $214.31 | $446.7K | 8.0K | 6.0K |
| 2016 | $301.88 | $173.88 | 1.74x | $128.00 | $655.3K | 9.6K | 7.4K |
| 2017 | $232.24 | $124.76 | 1.86x | $107.48 | $728.8K | 9.7K | 7.9K |
| 2018 | $170.88 | $125.82 | 1.36x | $45.06 | $772.0K | 9.5K | 7.8K |
| 2019 | $185.63 | $130.87 | 1.42x | $54.76 | $808.1K | 9.7K | 7.9K |
| 2020 | $155.10 | $112.56 | 1.38x | $42.54 | $683.0K | 8.0K | 6.6K |
| 2021 | $211.94 | $161.74 | 1.31x | $50.20 | $773.4K | 8.2K | 6.6K |
| 2022 | $194.94 | $144.16 | 1.35x | $50.78 | $869.8K | 9.2K | 7.5K |
| 2023 | $199.29 | $141.39 | 1.41x | $57.90 | $858.7K | 9.8K | 8.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 22.7K | $1.5M | $67.54 | 1.48x |
| 93976 | Ultrasound limited scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 8.6K | $1.2M | $141.94 | 1.56x |
| 51728 | Insertion of electronic device into bladder with voiding pressure studies | 3.1K | $1.0M | $332.64 | 1.29x |
| 76770 | Ultrasound behind abdominal cavity | 8.5K | $883.9K | $104.08 | 1.45x |
| 76872 | Ultrasound of rectum | 3.8K | $388.3K | $102.06 | 1.64x |
| 51729 | Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies | 942 | $316.2K | $335.70 | 1.31x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.3K | $315.7K | $95.50 | 1.44x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 10.2K | $142.0K | $13.94 | 1.50x |
| 76775 | Ultrasound behind abdominal cavity, limited | 2.4K | $138.8K | $58.12 | 2.19x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 464 | $125.2K | $269.85 | 1.81x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 181 | $122.9K | $679.15 | 1.99x |
| 51797 | Insertion of device into the abdomen with measurement of pressure and urine flow rate | 941 | $122.9K | $130.56 | 1.45x |
| 76857 | Ultrasound of pelvis | 2.2K | $107.2K | $48.35 | 2.19x |
| 51703 | Insertion of indwelling bladder catheter | 841 | $106.9K | $127.11 | 1.54x |
| 51784 | Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings | 1.4K | $102.6K | $73.01 | 2.03x |
| 55899 | Other procedure on male genital system | 315 | $82.5K | $261.82 | 1.91x |
| 52204 | Biopsy of the bladder using an endoscope | 231 | $81.4K | $352.25 | 1.78x |
| 76870 | Ultrasound of scrotum | 1.1K | $79.6K | $74.84 | 1.76x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 430 | $44.6K | $103.72 | 1.43x |
| 81002 | Urinalysis, manual test | 13.0K | $44.5K | $3.42 | 4.85x |
This provider submits charges 1.56 times higher than what Medicare actually pays.
A markup ratio of 1.56x means for every $100 Medicare pays, this provider initially charges $156. This is lower 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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