⚠️ This provider averages 1.2K services per working day — physically unusual for an individual practitioner
Based on 3.1M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.3M in total Medicare payments ranks in the 99th percentile of Urology providers nationally.
Averaging 1.2K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 730% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 181% in 2021
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 | $181.33 | $45.18 | 4.01x | $136.15 | $414.7K | 9.2K | 28 |
| 2015 | $25.29 | $6.19 | 4.09x | $19.10 | $646.8K | 104.4K | 27 |
| 2016 | $16.74 | $3.97 | 4.22x | $12.77 | $726.1K | 182.9K | 30 |
| 2017 | $13.06 | $3.24 | 4.03x | $9.82 | $866.8K | 267.3K | 31 |
| 2018 | $9.65 | $2.33 | 4.14x | $7.32 | $700.0K | 299.8K | 29 |
| 2019 | $8.05 | $2.00 | 4.03x | $6.05 | $778.0K | 388.6K | 25 |
| 2020 | $7.72 | $1.98 | 3.90x | $5.74 | $781.7K | 394.2K | 25 |
| 2021 | $13.63 | $4.79 | 2.85x | $8.84 | $2.2M | 458.3K | 23 |
| 2022 | $16.05 | $5.62 | 2.86x | $10.43 | $2.7M | 488.8K | 26 |
| 2023 | $18.52 | $6.60 | 2.81x | $11.92 | $3.4M | 521.2K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87150 | Identification of organisms by genetic analysis, amplified probe technique | 77.5K | $2.7M | $34.43 | 2.56x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 21.8K | $1.8M | $81.96 | 3.81x |
| 52224 | Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm | 3.2K | $1.7M | $548.18 | 3.61x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 19.4K | $1.3M | $68.89 | 2.54x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16.7K | $931.0K | $55.91 | 3.80x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 12.7K | $694.5K | $54.65 | 3.89x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 12.9K | $445.8K | $34.44 | 2.90x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 12.9K | $445.5K | $34.45 | 1.28x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 6.5K | $223.2K | $34.43 | 2.56x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 6.5K | $223.2K | $34.43 | 2.56x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 6.5K | $223.2K | $34.43 | 2.90x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 6.5K | $223.1K | $34.43 | 2.56x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 6.5K | $223.1K | $34.43 | 2.56x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 1.2K | $187.9K | $151.32 | 4.43x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 1.8K | $183.7K | $101.07 | 3.85x |
| 96372 | Injection of drug or substance under skin or into muscle | 13.6K | $176.7K | $13.04 | 5.57x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 2.3K | $162.8K | $72.38 | 4.32x |
| 50590 | Shock wave crushing of kidney stones | 354 | $151.2K | $427.13 | 3.95x |
| 51729 | Complex measurement of pressure of urine flow in bladder (cystometrogram) with bladder canal (urethra) pressure and voiding pressure studies | 498 | $127.1K | $255.16 | 3.81x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 10.4K | $102.7K | $9.84 | 5.52x |
This provider submits charges 3.29 times higher than what Medicare actually pays.
A markup ratio of 3.29x means for every $100 Medicare pays, this provider initially charges $329. 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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