This provider's $5.7M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.27x is significantly above the specialty median of 6.1x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 221% in 2023
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 | $1.5K | $257.67 | 5.98x | $1.3K | $734.2K | 3.2K | 2.5K |
| 2015 | $1.6K | $268.84 | 5.87x | $1.3K | $661.3K | 2.7K | 2.2K |
| 2016 | $1.6K | $290.90 | 5.43x | $1.3K | $673.2K | 2.6K | 2.1K |
| 2017 | $1.5K | $250.64 | 6.13x | $1.3K | $549.4K | 2.4K | 1.9K |
| 2018 | $1.5K | $255.13 | 6.02x | $1.3K | $423.8K | 1.8K | 1.4K |
| 2019 | $1.6K | $279.61 | 5.57x | $1.3K | $436.5K | 1.7K | 1.3K |
| 2020 | $4.4K | $1.5K | 2.93x | $2.9K | $602.6K | 1.3K | 1.0K |
| 2021 | $2.0K | $482.48 | 4.19x | $1.5K | $322.7K | 1.0K | 669 |
| 2022 | $2.2K | $546.19 | 3.94x | $1.6K | $298.5K | 880 | 644 |
| 2023 | $5.0K | $1.8K | 2.80x | $3.2K | $958.9K | 916 | 713 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 3.8K | $767.3K | $200.87 | 4.78x |
| 63685 | Insertion of spinal neurostimulator pulse generator or receiver | 45 | $739.5K | $16.4K | 2.43x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 2.9K | $629.0K | $219.09 | 8.53x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 1.5K | $505.1K | $329.92 | 5.67x |
| 45380 | Biopsy of large bowel using an endoscope | 1.4K | $386.9K | $282.39 | 6.62x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 1.1K | $347.7K | $316.39 | 5.41x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 97 | $320.4K | $3.3K | 2.57x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 1.4K | $280.6K | $205.85 | 4.71x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 981 | $258.0K | $262.97 | 6.50x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 681 | $210.7K | $309.37 | 5.61x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 937 | $192.1K | $205.00 | 8.34x |
| 64490 | Injections of upper or middle spine facet joint using imaging guidance | 919 | $190.3K | $207.07 | 4.64x |
| 43450 | Dilation of esophagus | 719 | $151.3K | $210.38 | 6.90x |
| 43249 | Balloon dilation of esophagus using an endoscope | 335 | $148.8K | $444.23 | 4.20x |
| 62311 | Injections of substances into lower or sacral spine | 550 | $131.2K | $238.47 | 4.07x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 408 | $110.7K | $271.31 | 6.89x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 336 | $86.6K | $257.73 | 3.78x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 138 | $76.6K | $555.38 | 5.40x |
| 0275T | Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin | 16 | $55.6K | $3.5K | 2.59x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 80 | $37.8K | $472.87 | 3.62x |
This provider submits charges 5.27 times higher than what Medicare actually pays.
A markup ratio of 5.27x means for every $100 Medicare pays, this provider initially charges $527. 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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