This provider's $8.3M in total Medicare payments ranks in the 99th percentile of Pathology 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 | $289.85 | $89.86 | 3.23x | $199.99 | $725.5K | 9.0K | 7.4K |
| 2015 | $260.19 | $78.12 | 3.33x | $182.07 | $916.3K | 11.2K | 9.1K |
| 2016 | $266.39 | $79.20 | 3.36x | $187.19 | $910.7K | 12.0K | 9.6K |
| 2017 | $399.07 | $104.84 | 3.81x | $294.23 | $794.5K | 10.1K | 8.4K |
| 2018 | $384.52 | $111.77 | 3.44x | $272.75 | $786.4K | 8.4K | 7.0K |
| 2019 | $365.59 | $105.29 | 3.47x | $260.30 | $849.4K | 8.9K | 7.4K |
| 2020 | $412.10 | $119.17 | 3.46x | $292.93 | $739.2K | 7.3K | 6.1K |
| 2021 | $429.70 | $131.71 | 3.26x | $297.99 | $819.8K | 7.1K | 6.0K |
| 2022 | $443.30 | $126.17 | 3.51x | $317.13 | $813.1K | 7.4K | 6.3K |
| 2023 | $568.57 | $171.38 | 3.32x | $397.19 | $940.6K | 7.3K | 5.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88120 | Cell examination of urine | 9.7K | $3.9M | $400.06 | 2.86x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens | 5.3K | $1.4M | $257.43 | 4.11x |
| 88112 | Cell examination of specimen | 27.2K | $1.0M | $38.60 | 4.06x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 23.1K | $914.1K | $39.60 | 3.09x |
| 88342 | Tissue or cell analysis by immunologic technique | 18.1K | $851.4K | $47.04 | 3.20x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 4.2K | $188.0K | $44.26 | 3.65x |
| 88377 | Microscopic genetic examination manual | 419 | $22.8K | $54.39 | 3.79x |
| 88108 | Cell examination of specimen | 125 | $7.5K | $59.96 | 2.67x |
| 88341 | Special stained specimen slides to examine tissue | 176 | $5.4K | $30.51 | 4.08x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 116 | $4.9K | $41.82 | 3.08x |
| 88363 | Microscopic genetic analysis of tissue | 199 | $4.1K | $20.38 | 2.21x |
| 88367 | Microscopic genetic analysis of tissue | 76 | $3.9K | $50.94 | 4.21x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 46 | $1.3K | $28.88 | 3.98x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 22 | $553.84 | $25.17 | 4.32x |
| 88302 | Pathology examination of tissue using a microscope | 12 | $184.51 | $15.38 | 7.11x |
This provider submits charges 3.3 times higher than what Medicare actually pays.
A markup ratio of 3.3x means for every $100 Medicare pays, this provider initially charges $330. 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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