This provider's $8.9M in total Medicare payments ranks in the 96th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 18.33x is significantly above the specialty median of 6.1x.
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 | $5.2K | $316.75 | 16.47x | $4.9K | $755.4K | 2.5K | 2.3K |
| 2015 | $5.2K | $341.09 | 15.18x | $4.8K | $895.3K | 2.7K | 2.5K |
| 2016 | $5.5K | $331.28 | 16.54x | $5.1K | $921.4K | 2.9K | 2.7K |
| 2017 | $5.6K | $332.33 | 16.91x | $5.3K | $952.5K | 3.0K | 2.8K |
| 2018 | $5.9K | $335.02 | 17.49x | $5.5K | $1.0M | 3.0K | 2.8K |
| 2019 | $6.7K | $438.74 | 15.18x | $6.2K | $1.0M | 3.0K | 2.7K |
| 2020 | $6.8K | $377.06 | 18.06x | $6.4K | $761.1K | 2.2K | 2.0K |
| 2021 | $7.4K | $402.40 | 18.30x | $7.0K | $895.6K | 2.4K | 2.2K |
| 2022 | $7.5K | $407.04 | 18.48x | $7.1K | $821.4K | 2.2K | 2.1K |
| 2023 | $7.5K | $466.02 | 16.18x | $7.1K | $844.4K | 2.1K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 5.0K | $1.9M | $367.82 | 16.56x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 4.8K | $1.2M | $240.15 | 25.50x |
| 43259 | Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope | 1.6K | $758.5K | $480.68 | 17.86x |
| 43242 | Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using an endoscope | 1.5K | $746.4K | $490.74 | 11.48x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 2.3K | $677.4K | $295.31 | 18.82x |
| 45380 | Biopsy of large bowel using an endoscope | 2.4K | $635.0K | $266.58 | 21.24x |
| 43270 | Destruction of growths on esophagus, stomach, and/or upper small bowel using an endoscope | 1.1K | $536.3K | $496.58 | 24.66x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 1.4K | $407.0K | $286.44 | 20.03x |
| 43253 | Injection of diagnostic or therapeutic substances or markers in esophagus, stomach, and/or upper small bowel using an endoscope | 542 | $266.1K | $490.93 | 12.39x |
| 43244 | Tying of dilated veins of stomach and/or esophagus using an endoscope | 436 | $208.2K | $477.57 | 15.36x |
| 45381 | Injections of large bowel using an endoscope | 988 | $196.5K | $198.93 | 11.93x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 629 | $181.9K | $289.19 | 19.98x |
| 43237 | Ultrasound examination of esophagus, stomach, and/or upper small bowel using an endoscope | 349 | $173.9K | $498.17 | 13.34x |
| 43249 | Balloon dilation of esophagus using an endoscope | 324 | $162.2K | $500.57 | 12.22x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 377 | $136.5K | $362.07 | 21.08x |
| 43254 | Removal of tissue lining of esophagus, stomach, and/or upper small bowel using an endoscope | 303 | $133.7K | $441.37 | 12.42x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 304 | $107.8K | $354.70 | 19.36x |
| 45388 | Destruction of large bowel growths using an endoscope | 302 | $103.5K | $342.77 | 24.82x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 216 | $101.7K | $471.00 | 12.04x |
| 44361 | Biopsy of small bowel using an endoscope | 150 | $72.7K | $484.57 | 15.56x |
This provider submits charges 18.33 times higher than what Medicare actually pays.
A markup ratio of 18.33x means for every $100 Medicare pays, this provider initially charges $1833. 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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