This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 175% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 292% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $335.94 | $159.44 | 2.11x | $176.50 | $135.5K | 1.1K | 967 |
| 2017 | $336.00 | $161.04 | 2.09x | $174.96 | $531.6K | 5.4K | 3.7K |
| 2018 | $335.55 | $148.59 | 2.26x | $186.96 | $485.5K | 5.3K | 3.3K |
| 2019 | $335.99 | $140.73 | 2.39x | $195.26 | $510.8K | 5.7K | 3.5K |
| 2020 | $192.94 | $80.75 | 2.39x | $112.19 | $382.5K | 7.3K | 4.7K |
| 2021 | $191.36 | $81.13 | 2.36x | $110.23 | $460.9K | 8.3K | 5.7K |
| 2022 | $193.02 | $81.47 | 2.37x | $111.55 | $434.9K | 7.7K | 5.2K |
| 2023 | $193.01 | $80.99 | 2.38x | $112.02 | $372.1K | 7.0K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88342 | Tissue or cell analysis by immunologic technique | 11.5K | $755.2K | $65.39 | 2.94x |
| 87507 | Detection test for digestive tract pathogen | 1.4K | $692.1K | $511.17 | 1.96x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 12.0K | $551.2K | $46.02 | 5.19x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 10.9K | $459.2K | $42.19 | 2.37x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 7.0K | $399.9K | $57.53 | 2.37x |
| 87506 | Detection test for digestive tract pathogen | 1.2K | $304.9K | $260.63 | 1.35x |
| 88341 | Special stained specimen slides to examine tissue | 3.9K | $151.2K | $38.86 | 3.71x |
This provider submits charges 2.85 times higher than what Medicare actually pays.
A markup ratio of 2.85x means for every $100 Medicare pays, this provider initially charges $285. 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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