This provider's $16.2M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $1.2K | $273.14 | 4.29x | $898.91 | $1.5M | 6.1K | 6.0K |
| 2015 | $1.2K | $261.44 | 4.41x | $890.56 | $1.5M | 5.8K | 5.7K |
| 2016 | $1.2K | $287.68 | 4.10x | $892.60 | $1.6M | 5.9K | 5.8K |
| 2017 | $1.2K | $275.99 | 4.23x | $890.90 | $1.7M | 6.1K | 6.0K |
| 2018 | $1.2K | $298.54 | 3.93x | $875.03 | $1.6M | 6.0K | 5.9K |
| 2019 | $1.2K | $298.16 | 3.95x | $879.99 | $1.8M | 6.3K | 6.2K |
| 2020 | $1.2K | $319.34 | 3.69x | $858.60 | $1.5M | 5.1K | 5.0K |
| 2021 | $1.2K | $327.06 | 3.60x | $848.99 | $1.7M | 5.5K | 5.4K |
| 2022 | $1.2K | $324.39 | 3.64x | $856.11 | $1.7M | 5.5K | 5.4K |
| 2023 | $1.2K | $337.49 | 3.45x | $828.10 | $1.7M | 5.1K | 5.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 15.6K | $5.1M | $326.57 | 3.87x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 12.0K | $2.4M | $204.22 | 6.19x |
| 45380 | Biopsy of large bowel using an endoscope | 8.9K | $2.3M | $254.33 | 4.97x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 5.1K | $1.6M | $306.86 | 4.12x |
| 43249 | Balloon dilation of esophagus using an endoscope | 2.3K | $990.6K | $438.70 | 2.88x |
| 44361 | Biopsy of small bowel using an endoscope | 2.4K | $970.9K | $400.68 | 3.16x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 2.4K | $724.7K | $301.08 | 4.20x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 2.0K | $480.6K | $236.87 | 5.34x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 2.0K | $455.4K | $227.61 | 4.10x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.9K | $413.5K | $218.08 | 5.80x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 433 | $192.5K | $444.60 | 2.59x |
| 43237 | Ultrasound examination of esophagus, stomach, and/or upper small bowel using an endoscope | 263 | $125.1K | $475.63 | 2.66x |
| 45381 | Injections of large bowel using an endoscope | 499 | $91.4K | $183.11 | 6.28x |
| 44360 | Examination of small bowel using an endoscope | 222 | $86.3K | $388.68 | 2.95x |
| 43259 | Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope | 200 | $82.9K | $414.26 | 3.05x |
| 43450 | Dilation of esophagus | 343 | $67.8K | $197.64 | 4.29x |
| 45331 | Biopsy of large bowel using an endoscope | 196 | $39.8K | $203.21 | 4.76x |
| 45388 | Destruction of large bowel growths using an endoscope | 105 | $32.1K | $306.15 | 4.13x |
| 44364 | Removal of small bowel polyps or growths using an endoscope | 57 | $25.9K | $454.43 | 2.78x |
| 43246 | Insertion of stomach tube using an endoscope | 60 | $24.2K | $403.45 | 2.85x |
This provider submits charges 4.4 times higher than what Medicare actually pays.
A markup ratio of 4.4x means for every $100 Medicare pays, this provider initially charges $440. 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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