This provider's $6.1M in total Medicare payments ranks in the 99th percentile of Colorectal Surgery (Proctology) providers nationally.
Medicare payments to this provider grew 100% from 2014 to 2023.
64% of their billing comes from a single procedure code (45388 — Destruction of large bowel growths using an endoscope).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 202% in 2016
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 | $341.32 | $163.25 | 2.09x | $178.07 | $306.4K | 1.9K | 1.5K |
| 2015 | $493.37 | $168.68 | 2.92x | $324.69 | $328.5K | 2.6K | 1.8K |
| 2016 | $742.04 | $325.83 | 2.28x | $416.21 | $991.0K | 3.0K | 2.1K |
| 2017 | $779.29 | $337.51 | 2.31x | $441.78 | $692.9K | 2.3K | 1.6K |
| 2018 | $743.17 | $357.60 | 2.08x | $385.57 | $783.2K | 2.3K | 1.6K |
| 2019 | $759.60 | $340.83 | 2.23x | $418.77 | $678.4K | 2.2K | 1.5K |
| 2020 | $795.68 | $388.63 | 2.05x | $407.05 | $608.5K | 1.8K | 1.4K |
| 2021 | $754.64 | $382.88 | 1.97x | $371.76 | $536.9K | 1.8K | 1.3K |
| 2022 | $1.1K | $335.43 | 3.24x | $752.53 | $592.9K | 2.0K | 1.4K |
| 2023 | $852.26 | $367.08 | 2.32x | $485.18 | $611.9K | 1.9K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45388 | Destruction of large bowel growths using an endoscope | 1.3K | $3.9M | $2.9K | 1.87x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.1K | $715.0K | $70.60 | 2.27x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.0K | $328.3K | $327.34 | 1.97x |
| 46500 | Injection of hemorrhoids | 1.1K | $255.8K | $241.74 | 1.65x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.4K | $140.5K | $98.45 | 2.21x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 310 | $130.4K | $420.77 | 1.69x |
| G6024 | Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare tehnique | 221 | $110.4K | $499.47 | 3.64x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 419 | $106.4K | $253.90 | 3.28x |
| 45383 | Removal of polyps or growths in large bowel using an endoscope | 200 | $102.6K | $512.91 | 1.49x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 147 | $59.6K | $405.37 | 1.64x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 480 | $58.1K | $121.10 | 7.69x |
| 45300 | Diagnostic examination of rectum and large bowel using an endoscope | 477 | $51.6K | $108.10 | 2.03x |
| 46600 | Diagnostic examination of the anus using an endoscope | 364 | $32.8K | $90.04 | 1.66x |
| 46942 | Repair of anal tear with dilation of anal muscle | 153 | $31.7K | $207.30 | 1.67x |
| 46940 | Repair of anal tear with dilation of anal muscle | 95 | $20.8K | $218.86 | 1.66x |
| 87635 | Sars-cov-2 covid-19 amp prb | 375 | $19.2K | $51.27 | 1.79x |
| 44386 | Biopsy of small bowel pouch using an endoscope | 112 | $17.4K | $155.34 | 4.59x |
| 93041 | Tracing of electrical activity of the heart using 1-3 leads | 2.9K | $16.9K | $5.83 | 12.76x |
| 45380 | Biopsy of large bowel using an endoscope | 136 | $11.4K | $83.64 | 10.24x |
| 12021 | Repair of separation of wound closure with insertion of packing | 29 | $3.8K | $129.44 | 2.16x |
This provider submits charges 2.07 times higher than what Medicare actually pays.
A markup ratio of 2.07x means for every $100 Medicare pays, this provider initially charges $207. 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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