This provider's $36.0M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.16x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 77% 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 | $1.3K | $252.02 | 5.22x | $1.1K | $2.4M | 9.5K | 20 |
| 2015 | $1.3K | $269.26 | 4.88x | $1.0K | $3.1M | 11.7K | 23 |
| 2016 | $1.3K | $271.73 | 4.84x | $1.0K | $3.4M | 12.6K | 25 |
| 2017 | $1.3K | $273.36 | 4.81x | $1.0K | $3.5M | 12.9K | 24 |
| 2018 | $1.3K | $283.06 | 4.66x | $1.0K | $3.8M | 13.5K | 23 |
| 2019 | $1.3K | $290.90 | 4.52x | $1.0K | $4.1M | 14.1K | 24 |
| 2020 | $1.3K | $293.02 | 4.47x | $1.0K | $3.5M | 11.9K | 21 |
| 2021 | $1.3K | $308.48 | 4.26x | $1.0K | $3.9M | 12.7K | 21 |
| 2022 | $1.6K | $308.14 | 5.25x | $1.3K | $3.9M | 12.7K | 20 |
| 2023 | $2.7K | $328.76 | 8.27x | $2.4K | $4.2M | 12.9K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45380 | Biopsy of large bowel using a flexible endoscope | 35.3K | $10.8M | $306.51 | 5.06x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 20.6K | $7.3M | $355.14 | 4.59x |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 26.8K | $5.8M | $214.41 | 6.72x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 7.4K | $2.5M | $338.00 | 4.44x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 6.6K | $2.2M | $334.15 | 5.00x |
| 45378 | Diagnostic exam of large bowel using a flexible endoscope | 5.3K | $1.4M | $260.02 | 5.53x |
| 43248 | Insertion of guide wire with dilation of esophagus using a flexible endoscope | 5.4K | $1.4M | $255.92 | 5.68x |
| 43235 | Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 5.2K | $1.2M | $223.20 | 5.52x |
| 43249 | Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | 2.0K | $939.7K | $472.22 | 3.24x |
| 43450 | Dilation of esophagus | 2.3K | $546.2K | $233.62 | 4.63x |
| 45331 | Biopsy of lower large bowel using a flexible endoscope | 2.0K | $475.7K | $235.72 | 4.74x |
| 45381 | Injection beneath lining of large bowel using a flexible endoscope | 1.5K | $304.3K | $206.16 | 5.76x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare | 423 | $197.5K | $467.02 | 3.40x |
| 43245 | Dilation of stomach outlet using a flexible endoscope | 345 | $157.5K | $456.64 | 3.40x |
| 45388 | Destruction of polyp or growth of large bowel using a flexible endoscope | 365 | $122.4K | $335.22 | 4.82x |
| 43255 | Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 266 | $119.5K | $449.06 | 3.06x |
| 45330 | Diagnostic exam of lower portion of large bowel using a flexible endoscope | 1.1K | $102.5K | $91.11 | 9.36x |
| 43270 | Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 169 | $83.7K | $495.51 | 3.38x |
| 45338 | Removal of polyps or growths of lower large bowel using a flexible endoscope with mechanical snare | 212 | $74.9K | $353.27 | 3.63x |
| 43244 | Tying of dilated veins of stomach and/or esophagus using a flexible endoscope | 129 | $59.8K | $463.47 | 2.73x |
This provider submits charges 5.16 times higher than what Medicare actually pays.
A markup ratio of 5.16x means for every $100 Medicare pays, this provider initially charges $516. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in TN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Knoxville Eye Surgery Center Llc | Knoxville, TN | $33.5M | ✓ Clear |
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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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