This provider's $3.4M in total Medicare payments ranks in the 90th percentile of Ambulatory Surgical Center 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 | $1.2K | $246.57 | 4.83x | $945.40 | $340.7K | 1.2K | 1.2K |
| 2015 | $1.2K | $270.90 | 4.55x | $962.99 | $380.4K | 1.2K | 1.2K |
| 2016 | $1.2K | $286.39 | 4.31x | $949.32 | $392.5K | 1.2K | 1.2K |
| 2017 | $1.3K | $308.75 | 4.11x | $960.00 | $307.0K | 959 | 950 |
| 2018 | $1.2K | $291.19 | 4.24x | $944.52 | $369.6K | 1.1K | 1.1K |
| 2019 | $1.3K | $329.75 | 3.79x | $920.25 | $358.5K | 1.1K | 1.0K |
| 2020 | $1.2K | $298.46 | 3.96x | $882.79 | $273.8K | 815 | 806 |
| 2021 | $1.2K | $314.78 | 3.92x | $920.66 | $293.6K | 853 | 845 |
| 2022 | $1.3K | $358.19 | 3.70x | $966.52 | $333.4K | 956 | 945 |
| 2023 | $1.3K | $365.87 | 3.62x | $959.13 | $336.8K | 920 | 913 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 3.5K | $951.0K | $267.90 | 4.48x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 2.0K | $800.1K | $398.46 | 4.27x |
| 45380 | Biopsy of large bowel using an endoscope | 1.9K | $778.5K | $400.67 | 3.74x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 2.2K | $677.1K | $313.62 | 4.46x |
| 43450 | Dilation of esophagus | 306 | $86.3K | $281.89 | 3.61x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 254 | $71.4K | $281.22 | 3.91x |
| 45330 | Diagnostic examination of large bowel using an endoscope | 93 | $8.6K | $92.58 | 7.42x |
| 45331 | Biopsy of large bowel using an endoscope | 26 | $7.0K | $267.72 | 2.99x |
| 43245 | Dilation of stomach outlet using an endoscope | 13 | $6.4K | $490.12 | 3.06x |
This provider submits charges 4.22 times higher than what Medicare actually pays.
A markup ratio of 4.22x means for every $100 Medicare pays, this provider initially charges $422. 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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