⚠️ This provider averages 241 services per working day — physically unusual for an individual practitioner
Based on 603.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $40.6M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Averaging 241 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 451% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 207% in 2015
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 | $246.61 | $49.88 | 4.94x | $196.73 | $600.3K | 12.0K | 6 |
| 2015 | $280.94 | $91.63 | 3.07x | $189.31 | $1.8M | 20.1K | 12 |
| 2016 | $301.88 | $144.00 | 2.10x | $157.88 | $4.3M | 29.8K | 15 |
| 2017 | $244.82 | $106.85 | 2.29x | $137.97 | $5.3M | 49.8K | 20 |
| 2018 | $209.89 | $67.36 | 3.12x | $142.53 | $4.8M | 70.8K | 20 |
| 2019 | $192.52 | $56.94 | 3.38x | $135.58 | $5.0M | 88.6K | 32 |
| 2020 | $168.70 | $67.52 | 2.50x | $101.18 | $6.2M | 91.2K | 29 |
| 2021 | $157.07 | $56.63 | 2.77x | $100.44 | $4.8M | 85.3K | 28 |
| 2022 | $169.37 | $54.92 | 3.08x | $114.45 | $4.4M | 80.4K | 31 |
| 2023 | $165.58 | $43.95 | 3.77x | $121.63 | $3.3M | 75.3K | 33 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87507 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets | 34.1K | $16.7M | $489.30 | 1.58x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 320.9K | $8.6M | $26.83 | 6.09x |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 41.0K | $3.6M | $87.76 | 1.14x |
| 88120 | Cell examination of urine, manual | 5.4K | $2.2M | $398.57 | 2.62x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 38.6K | $2.1M | $54.48 | 2.91x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 27.5K | $1.4M | $50.99 | 3.17x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 28.2K | $1.2M | $42.73 | 2.56x |
| 87506 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets | 4.5K | $1.2M | $257.54 | 1.57x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 4.8K | $773.9K | $161.93 | 7.38x |
| 88112 | Cell examination of specimen, selective cellular enhancement technique | 19.6K | $558.8K | $28.52 | 3.17x |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within | 18.8K | $467.4K | $24.86 | 1.01x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 8.4K | $414.9K | $49.27 | 3.68x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 6.4K | $232.8K | $36.24 | 1.93x |
| 88377 | Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure | 632 | $155.7K | $246.36 | 1.58x |
| 88344 | Special stained specimen slides to examine tissue, each multiplex procedure | 1.4K | $129.1K | $95.26 | 3.17x |
| 87633 | Detection test for multiple types of respiratory virus | 297 | $127.1K | $427.78 | 1.75x |
| 36415 | Insertion of needle into vein for collection of blood sample | 23.0K | $79.6K | $3.45 | 2.42x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 1.9K | $68.4K | $35.57 | 1.97x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 681 | $67.9K | $99.72 | 1.42x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 1.8K | $65.5K | $35.61 | 1.97x |
This provider submits charges 2.87 times higher than what Medicare actually pays.
A markup ratio of 2.87x means for every $100 Medicare pays, this provider initially charges $287. 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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