This provider's $5.1M 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 | $463.15 | $172.27 | 2.69x | $290.88 | $538.3K | 9.7K | 5.1K |
| 2015 | $540.77 | $198.16 | 2.73x | $342.61 | $596.0K | 10.3K | 5.5K |
| 2016 | $536.29 | $177.23 | 3.03x | $359.06 | $559.9K | 10.3K | 5.1K |
| 2017 | $489.58 | $181.90 | 2.69x | $307.68 | $505.4K | 10.1K | 4.8K |
| 2018 | $429.54 | $151.02 | 2.84x | $278.52 | $438.1K | 9.2K | 4.6K |
| 2019 | $443.22 | $160.23 | 2.77x | $282.99 | $477.5K | 10.2K | 4.5K |
| 2020 | $538.25 | $206.94 | 2.60x | $331.31 | $443.6K | 8.6K | 3.8K |
| 2021 | $545.85 | $214.38 | 2.55x | $331.47 | $511.9K | 9.3K | 4.0K |
| 2022 | $554.71 | $205.26 | 2.70x | $349.45 | $491.7K | 10.3K | 4.5K |
| 2023 | $497.68 | $180.97 | 2.75x | $316.71 | $513.1K | 10.7K | 5.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 18.2K | $1.1M | $59.51 | 2.59x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 4.4K | $724.2K | $164.41 | 2.74x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.0K | $723.4K | $90.87 | 2.48x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 787 | $451.6K | $573.81 | 2.53x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $180.0K | $122.34 | 2.86x |
| 64566 | Implantation of lower leg neurostimulator electrode, accessed through the skin | 1.8K | $174.0K | $99.15 | 2.52x |
| 52214 | Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endoscope | 272 | $157.4K | $578.74 | 2.42x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 12.2K | $145.9K | $11.98 | 4.17x |
| 53854 | Destruction of prostate tissue accessed through urethra using radiofrequency generated water vapor heat therapy | 92 | $135.3K | $1.5K | 2.72x |
| 53852 | Destruction of prostate tissue through bladder canal (urethra) | 70 | $108.3K | $1.5K | 2.59x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 7.6K | $107.5K | $14.06 | 4.27x |
| J3490 | Unclassified drugs | 152 | $100.0K | $657.74 | 1.37x |
| 76872 | Ultrasound of rectum | 959 | $86.4K | $90.13 | 2.26x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 125 | $78.0K | $623.72 | 2.93x |
| 81002 | Urinalysis, manual test | 20.4K | $69.9K | $3.42 | 2.92x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 260 | $62.3K | $239.47 | 2.40x |
| 51741 | Electronic assessment of bladder emptying | 7.1K | $60.5K | $8.48 | 11.79x |
| 52001 | Irrigation and removal of multiple blood clots from bladder and bladder canal (urethra) using an endoscope | 205 | $57.4K | $280.04 | 3.04x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.5K | $54.6K | $37.05 | 2.69x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 324 | $53.1K | $163.79 | 3.06x |
This provider submits charges 2.82 times higher than what Medicare actually pays.
A markup ratio of 2.82x means for every $100 Medicare pays, this provider initially charges $282. 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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