This provider's $25.1M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.31x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 84% from 2014 to 2023.
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 | $925.19 | $185.27 | 4.99x | $739.92 | $1.8M | 10.0K | 19 |
| 2015 | $639.23 | $108.43 | 5.90x | $530.80 | $1.8M | 16.9K | 19 |
| 2016 | $477.96 | $82.58 | 5.79x | $395.38 | $2.1M | 25.6K | 18 |
| 2017 | $344.84 | $67.31 | 5.12x | $277.53 | $2.4M | 36.2K | 22 |
| 2018 | $303.75 | $56.89 | 5.34x | $246.86 | $2.7M | 47.5K | 20 |
| 2019 | $335.45 | $62.14 | 5.40x | $273.31 | $2.8M | 45.4K | 20 |
| 2020 | $308.60 | $57.09 | 5.41x | $251.51 | $2.5M | 44.2K | 20 |
| 2021 | $306.06 | $58.74 | 5.21x | $247.32 | $2.6M | 43.9K | 19 |
| 2022 | $331.04 | $64.12 | 5.16x | $266.92 | $2.8M | 43.6K | 20 |
| 2023 | $396.90 | $78.64 | 5.05x | $318.26 | $3.4M | 43.3K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64590 | Insertion of peripheral or gastric neurostimulator generator | 607 | $7.8M | $12.9K | 5.82x |
| 64561 | Insertion of sacral nerve neurostimulator electrode array | 1.2K | $4.3M | $3.5K | 3.45x |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 499 | $2.4M | $4.9K | 5.29x |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 7.7K | $1.6M | $214.91 | 9.57x |
| 64581 | Insertion of sacral nerve neurostimulator electrode | 446 | $1.6M | $3.6K | 5.10x |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 335.9K | $1.6M | $4.77 | 3.82x |
| 52287 | Exam with injections of chemical for destruction of bladder using an endoscope | 2.7K | $1.6M | $594.28 | 6.47x |
| 55700 | Biopsy of prostate gland | 1.4K | $828.8K | $597.14 | 4.46x |
| 57288 | Creation of sling around urethra in female to control leakage | 335 | $530.3K | $1.6K | 4.79x |
| 52310 | Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope | 850 | $487.7K | $573.75 | 5.24x |
| 51715 | Injection of implant material beneath lining of bladder and/or urethra using an endoscope | 296 | $377.4K | $1.3K | 3.09x |
| 52214 | Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope | 395 | $317.8K | $804.68 | 3.84x |
| 52356 | Crushing of stone of ureter with insertion of stent using an endoscope | 193 | $278.9K | $1.4K | 5.17x |
| 52332 | Insertion of stent in ureter using an endoscope | 332 | $270.1K | $813.63 | 3.95x |
| 64595 | Revision of peripheral or gastric neurostimulator generator | 75 | $123.5K | $1.6K | 6.55x |
| 52234 | Destruction and/or removal of (0.5 to 2.0 centimeters) small growths of the bladder using an endoscope | 131 | $117.8K | $899.35 | 3.18x |
| 52281 | Dilation of urethra using an endoscope | 164 | $94.8K | $577.76 | 5.28x |
| 57250 | Repair of herniated rectum into vaginal wall | 75 | $92.3K | $1.2K | 3.78x |
| 64585 | Revision or removal of peripheral neurostimulator electrode array | 85 | $86.5K | $1.0K | 5.91x |
| 76872 | Ultrasound scan of pelvic region through rectum | 1.9K | $85.5K | $44.41 | 15.04x |
This provider submits charges 5.31 times higher than what Medicare actually pays.
A markup ratio of 5.31x means for every $100 Medicare pays, this provider initially charges $531. 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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