This provider's $4.3M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Their average markup ratio of 6.59x is significantly above the specialty median of 3.8x.
Medicare payments to this provider grew 59% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 69% 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 | $1.2K | $136.57 | 9.07x | $1.1K | $318.2K | 4.7K | 3.2K |
| 2015 | $1.3K | $142.94 | 9.27x | $1.2K | $206.4K | 3.3K | 2.4K |
| 2016 | $671.76 | $156.16 | 4.30x | $515.60 | $348.3K | 4.4K | 2.9K |
| 2017 | $576.12 | $108.99 | 5.29x | $467.13 | $303.3K | 4.0K | 2.6K |
| 2018 | $821.35 | $161.93 | 5.07x | $659.42 | $371.4K | 4.2K | 2.9K |
| 2019 | $975.62 | $217.62 | 4.48x | $758.00 | $528.1K | 5.0K | 3.6K |
| 2020 | $889.74 | $207.05 | 4.30x | $682.69 | $433.4K | 3.9K | 3.0K |
| 2021 | $1.3K | $270.38 | 4.68x | $995.85 | $675.6K | 5.4K | 4.3K |
| 2022 | $1.1K | $172.69 | 6.35x | $923.44 | $570.7K | 4.9K | 4.1K |
| 2023 | $1.9K | $159.03 | 11.99x | $1.7K | $506.1K | 4.6K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 51728 | Insertion of electronic device into bladder with voiding pressure studies | 1.9K | $632.9K | $335.73 | 3.58x |
| 76705 | Ultrasound of abdomen | 5.7K | $468.8K | $82.32 | 4.51x |
| 51729 | Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies | 1.1K | $375.1K | $338.26 | 4.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.4K | $350.0K | $103.43 | 3.99x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 1.4K | $268.9K | $187.10 | 5.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.5K | $262.4K | $57.93 | 4.62x |
| 91122 | Study of anorectal pressure generated by muscles surrounding anus (sphincter) | 1.2K | $257.6K | $211.00 | 4.40x |
| 51784 | Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings | 4.5K | $253.6K | $56.87 | 17.90x |
| 76872 | Ultrasound of rectum | 1.4K | $156.7K | $112.22 | 5.44x |
| 51797 | Insertion of device into the abdomen with measurement of pressure and urine flow rate | 1.1K | $152.7K | $137.66 | 3.91x |
| 52601 | Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope | 204 | $146.1K | $716.27 | 5.83x |
| 0421T | Waterjet destruction of prostrate accessed through the urethra | 174 | $126.3K | $725.72 | 13.78x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 876 | $122.1K | $139.38 | 4.35x |
| 51600 | Injection procedure for X-ray imaging of the bladder or during voiding | 1.1K | $105.0K | $93.53 | 9.36x |
| 74455 | Radiological supervision and interpretation X-ray of urinary bladder and urethra | 1.1K | $96.0K | $86.35 | 4.53x |
| 52441 | Insertion of implant in bladder canal (urethra) within prostate gland using an endoscope | 41 | $53.9K | $1.3K | 3.85x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 577 | $49.7K | $86.11 | 5.07x |
| 51798 | Ultrasound measurement of bladder capacity after voiding | 3.0K | $45.3K | $14.98 | 14.52x |
| 51741 | Electronic assessment of bladder emptying | 4.6K | $41.5K | $9.00 | 37.49x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 63 | $39.0K | $618.74 | 7.79x |
This provider submits charges 6.59 times higher than what Medicare actually pays.
A markup ratio of 6.59x means for every $100 Medicare pays, this provider initially charges $659. 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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