This provider's $3.5M in total Medicare payments ranks in the 98th percentile of Urology 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 | $452.83 | $85.58 | 5.29x | $367.25 | $296.2K | 5.6K | 3.9K |
| 2015 | $495.94 | $102.91 | 4.82x | $393.03 | $376.2K | 7.0K | 4.7K |
| 2016 | $727.73 | $136.32 | 5.34x | $591.41 | $399.4K | 7.1K | 4.8K |
| 2017 | $522.26 | $102.82 | 5.08x | $419.44 | $385.4K | 6.9K | 4.5K |
| 2018 | $352.24 | $77.68 | 4.53x | $274.56 | $337.5K | 6.2K | 4.1K |
| 2019 | $393.40 | $86.53 | 4.55x | $306.87 | $303.0K | 5.7K | 3.8K |
| 2020 | $353.68 | $83.39 | 4.24x | $270.29 | $287.7K | 5.6K | 3.7K |
| 2021 | $492.93 | $122.10 | 4.04x | $370.83 | $374.7K | 6.6K | 4.3K |
| 2022 | $471.20 | $90.78 | 5.19x | $380.42 | $393.8K | 6.8K | 4.6K |
| 2023 | $284.91 | $58.16 | 4.90x | $226.75 | $363.3K | 7.4K | 5.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 76770 | Ultrasound behind abdominal cavity | 7.4K | $743.0K | $99.81 | 4.38x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.2K | $627.9K | $61.58 | 3.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.4K | $584.1K | $91.09 | 3.51x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 1.4K | $247.7K | $180.51 | 4.23x |
| 52281 | Dilation of bladder canal (urethra) using an endoscope | 656 | $174.7K | $266.30 | 4.14x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 923 | $120.4K | $130.41 | 3.69x |
| G9678 | Oncology Care Model service | 682 | $106.3K | $155.88 | 1.03x |
| 51741 | Electronic assessment of bladder emptying | 8.1K | $95.2K | $11.81 | 23.42x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 6.6K | $83.5K | $12.75 | 6.29x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 370 | $60.1K | $162.47 | 3.85x |
| 51720 | Bladder instillation of cancer preventive, inhibiting, or suppressive agent | 734 | $60.0K | $81.68 | 7.74x |
| 55700 | Biopsy of prostate gland | 251 | $52.6K | $209.61 | 4.55x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 299 | $50.4K | $168.54 | 3.53x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 366 | $48.1K | $131.32 | 3.25x |
| J9031 | Bcg (intravesical) per instillation | 375 | $36.3K | $96.93 | 2.06x |
| 52648 | Laser vaporization of prostate including control of bleeding using an endoscope | 22 | $32.4K | $1.5K | 4.76x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 889 | $31.5K | $35.44 | 1.48x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 46 | $30.0K | $652.21 | 4.92x |
| 52356 | Crushing of stone in urinary duct (ureter) with stent using an endoscope | 86 | $29.3K | $340.80 | 5.89x |
| 76870 | Ultrasound of scrotum | 401 | $28.9K | $71.95 | 5.18x |
This provider submits charges 4.57 times higher than what Medicare actually pays.
A markup ratio of 4.57x means for every $100 Medicare pays, this provider initially charges $457. 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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