This provider's $4.3M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Medicare payments to this provider grew 97% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 65% in 2020
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 | $572.69 | $152.39 | 3.76x | $420.30 | $312.1K | 4.9K | 3.3K |
| 2015 | $451.59 | $127.73 | 3.54x | $323.86 | $304.7K | 5.1K | 3.5K |
| 2016 | $460.34 | $118.41 | 3.89x | $341.93 | $358.1K | 5.0K | 3.7K |
| 2017 | $531.34 | $139.55 | 3.81x | $391.79 | $326.2K | 5.1K | 3.8K |
| 2018 | $461.32 | $114.52 | 4.03x | $346.80 | $339.7K | 6.2K | 4.5K |
| 2019 | $541.03 | $142.24 | 3.80x | $398.79 | $347.0K | 6.2K | 4.6K |
| 2020 | $422.51 | $132.00 | 3.20x | $290.51 | $571.0K | 11.9K | 8.5K |
| 2021 | $326.26 | $85.22 | 3.83x | $241.04 | $587.8K | 11.9K | 8.6K |
| 2022 | $309.76 | $109.39 | 2.83x | $200.37 | $582.0K | 12.0K | 8.4K |
| 2023 | $557.10 | $174.54 | 3.19x | $382.56 | $613.8K | 9.0K | 6.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 11.1K | $1.2M | $112.77 | 2.48x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 2.2K | $352.0K | $157.85 | 2.63x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 3.3K | $307.5K | $92.00 | 4.25x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.6K | $301.5K | $116.40 | 2.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.4K | $271.0K | $78.72 | 2.75x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 260 | $159.0K | $611.53 | 3.03x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 677 | $109.4K | $161.59 | 3.71x |
| 87801 | Detection test for multiple organisms | 1.2K | $82.9K | $69.92 | 1.77x |
| 81000 | Manual urinalysis test with examination using microscope | 19.7K | $79.4K | $4.03 | 2.98x |
| 87492 | Detection test for chlamydia | 1.4K | $75.2K | $53.12 | 1.64x |
| 55700 | Biopsy of prostate gland | 657 | $74.0K | $112.70 | 4.98x |
| 52353 | Crushing of stone in urinary duct (ureter) using an endoscope | 224 | $69.0K | $308.23 | 2.62x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 6.4K | $68.6K | $10.66 | 5.16x |
| 87592 | Detection test for neisseria gonorrhoeae (gonorrhoeae bacteria) | 1.4K | $60.3K | $42.56 | 1.64x |
| 87652 | Detection test for strep (streptococcus, group a) | 1.4K | $58.7K | $41.49 | 1.65x |
| 51702 | Insertion of indwelling bladder catheter | 1.1K | $52.7K | $46.47 | 3.15x |
| 53854 | Destruction of prostate tissue accessed through urethra using radiofrequency generated water vapor heat therapy | 37 | $50.4K | $1.4K | 1.76x |
| 51720 | Bladder instillation of cancer preventive, inhibiting, or suppressive agent | 691 | $49.8K | $72.06 | 3.02x |
| 87798 | Detection test for organism | 1.4K | $49.4K | $34.82 | 1.63x |
| 87500 | Detection test for vancomycin resistance strep (vre) | 1.4K | $49.4K | $34.86 | 1.66x |
This provider submits charges 2.89 times higher than what Medicare actually pays.
A markup ratio of 2.89x means for every $100 Medicare pays, this provider initially charges $289. 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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