This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Colorectal Surgery (Proctology) 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 61% in 2019
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 | $1.2K | $374.22 | 3.25x | $843.03 | $608.1K | 2.8K | 1.9K |
| 2015 | $2.1K | $374.30 | 5.48x | $1.7K | $706.7K | 3.0K | 2.1K |
| 2016 | $2.0K | $412.94 | 4.82x | $1.6K | $795.1K | 2.8K | 2.0K |
| 2017 | $2.0K | $376.71 | 5.42x | $1.7K | $655.1K | 2.4K | 1.8K |
| 2018 | $2.0K | $433.67 | 4.70x | $1.6K | $426.4K | 1.5K | 1.1K |
| 2019 | $2.4K | $427.63 | 5.61x | $2.0K | $685.9K | 2.0K | 1.5K |
| 2020 | $2.1K | $424.99 | 4.89x | $1.7K | $581.7K | 1.6K | 1.2K |
| 2021 | $2.0K | $425.38 | 4.79x | $1.6K | $586.8K | 1.7K | 1.2K |
| 2022 | $2.1K | $424.19 | 4.84x | $1.6K | $459.3K | 1.4K | 1.0K |
| 2023 | $2.1K | $427.02 | 5.02x | $1.7K | $422.0K | 1.1K | 789 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45303 | Dilation of rectum and large bowel using an endoscope | 2.4K | $1.6M | $694.07 | 1.91x |
| 46744 | Repair of defect for single channel outlet of rectum, vagina, and urinary tract | 204 | $544.2K | $2.7K | 2.16x |
| 49020 | Drainage of abdominal abscess or infection, open procedure | 435 | $360.5K | $828.75 | 5.29x |
| 44603 | Suture of multiple small bowel ulcers, defects, wounds, injuries, or rupture | 257 | $243.1K | $946.01 | 3.83x |
| 15734 | Muscle flap wound repair at trunk | 378 | $242.2K | $640.80 | 7.39x |
| 48105 | Removal of pancreatic tissue | 106 | $229.0K | $2.2K | 4.13x |
| 44700 | Suspension of small bowel using mesh or prosthesis | 540 | $210.4K | $389.56 | 7.92x |
| 44207 | Partial removal of large bowel and reattachment to rectum using an endoscope | 197 | $210.0K | $1.1K | 5.30x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.4K | $178.7K | $74.57 | 3.47x |
| 46604 | Dilation of anus using an endoscope | 352 | $171.7K | $487.67 | 2.78x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.0K | $157.8K | $78.70 | 3.25x |
| 46221 | Removal of hemorrhoid by rubber banding | 1.2K | $153.3K | $130.62 | 3.82x |
| 50715 | Release of scar tissue at urinary duct (ureter) | 288 | $141.6K | $491.80 | 7.35x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 904 | $135.9K | $150.38 | 3.50x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 728 | $118.5K | $162.76 | 4.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 801 | $91.0K | $113.66 | 4.08x |
| 49203 | Removal or destruction of (5 centimeters or less) abdominal cavity growths, cysts, or abnormal tissue, open procedure | 137 | $82.3K | $600.54 | 6.21x |
| 44205 | Partial removal of small and large bowel with attachment of small and large bowel using an endoscope | 129 | $81.9K | $634.73 | 6.54x |
| 49560 | Repair of incisional or abdominal hernia | 260 | $76.5K | $294.33 | 7.74x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.4K | $75.0K | $54.48 | 3.41x |
This provider submits charges 3.98 times higher than what Medicare actually pays.
A markup ratio of 3.98x means for every $100 Medicare pays, this provider initially charges $398. 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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