This provider's $5.1M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 159905% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1159% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $113.87 | $24.53 | 4.64x | $89.34 | $2.6K | 106 | 3 |
| 2017 | $139.42 | $31.43 | 4.44x | $107.99 | $30.5K | 969 | 9 |
| 2018 | $143.00 | $33.90 | 4.22x | $109.10 | $30.6K | 902 | 9 |
| 2019 | $142.97 | $33.76 | 4.23x | $109.21 | $30.0K | 889 | 9 |
| 2020 | $154.51 | $37.70 | 4.10x | $116.81 | $39.2K | 1.0K | 16 |
| 2021 | $158.27 | $40.49 | 3.91x | $117.78 | $60.6K | 1.5K | 13 |
| 2022 | $151.12 | $77.00 | 1.96x | $74.12 | $762.8K | 9.9K | 15 |
| 2023 | $161.44 | $75.18 | 2.15x | $86.26 | $4.2M | 55.3K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 17.6K | $1.6M | $91.60 | 2.99x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 12.5K | $1.2M | $92.83 | 1.46x |
| 88381 | Preparation of specimen, manual | 3.1K | $525.4K | $170.31 | 1.47x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 9.8K | $489.9K | $49.94 | 2.61x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 6.2K | $421.9K | $67.77 | 1.40x |
| 87799 | Detection test by nucleic acid for organism, quantification | 7.0K | $295.9K | $41.97 | 1.79x |
| G0452 | Molecular pathology procedure; physician interpretation and report | 5.7K | $214.1K | $37.72 | 1.50x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 1.3K | $150.3K | $117.95 | 3.33x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 2.0K | $67.5K | $34.39 | 1.29x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 789 | $41.4K | $52.45 | 3.05x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 687 | $17.8K | $25.85 | 4.35x |
| 99451 | Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes | 676 | $17.0K | $25.10 | 5.10x |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 202 | $15.2K | $75.05 | 3.48x |
| 88173 | Evaluation of fine needle aspirate with interpretation and report | 172 | $10.8K | $63.04 | 3.86x |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 412 | $9.0K | $21.90 | 2.53x |
| 80502 | Comprehensive, clinical pathology consultation | 132 | $8.3K | $62.63 | 3.19x |
| 88177 | Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode | 368 | $7.4K | $20.16 | 3.86x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 231 | $7.4K | $32.01 | 5.50x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 151 | $5.2K | $34.39 | 1.31x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 151 | $5.2K | $34.39 | 1.31x |
This provider submits charges 2.2 times higher than what Medicare actually pays.
A markup ratio of 2.2x means for every $100 Medicare pays, this provider initially charges $220. 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 Pathology providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Jon Keller, MD | Palo Alto, CA | $61.6M | ✓ 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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