This provider's $6.6M in total Medicare payments ranks in the 95th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.57x is significantly above the specialty median of 6.1x.
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 | $1.8K | $314.46 | 5.65x | $1.5K | $544.9K | 2.3K | 2.2K |
| 2015 | $1.9K | $345.64 | 5.51x | $1.6K | $624.2K | 2.4K | 2.2K |
| 2016 | $1.9K | $345.95 | 5.63x | $1.6K | $594.6K | 2.3K | 2.2K |
| 2017 | $1.9K | $311.62 | 6.03x | $1.6K | $603.3K | 2.4K | 2.2K |
| 2018 | $2.0K | $301.74 | 6.55x | $1.7K | $749.4K | 2.9K | 2.7K |
| 2019 | $2.1K | $331.13 | 6.45x | $1.8K | $745.8K | 3.0K | 2.8K |
| 2020 | $2.2K | $400.55 | 5.56x | $1.8K | $651.6K | 2.4K | 2.3K |
| 2021 | $2.3K | $416.06 | 5.60x | $1.9K | $772.1K | 2.6K | 2.5K |
| 2022 | $2.5K | $375.02 | 6.53x | $2.1K | $694.8K | 2.4K | 2.3K |
| 2023 | $2.5K | $425.07 | 5.97x | $2.1K | $626.9K | 2.0K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45380 | Biopsy of large bowel using an endoscope | 5.9K | $1.8M | $297.53 | 6.80x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 8.8K | $1.7M | $190.90 | 10.64x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 3.5K | $1.3M | $368.80 | 5.55x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 3.4K | $803.7K | $236.66 | 8.49x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 892 | $273.5K | $306.67 | 6.63x |
| 43251 | Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope | 302 | $145.6K | $482.11 | 4.21x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 454 | $134.5K | $296.22 | 6.76x |
| 43249 | Balloon dilation of esophagus using an endoscope | 158 | $85.4K | $540.25 | 4.36x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 351 | $82.4K | $234.89 | 8.69x |
| 43252 | Microscopic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 63 | $64.0K | $1.0K | 2.17x |
| 43229 | Destruction of growths of esophagus using an endoscope | 71 | $60.5K | $852.18 | 5.01x |
| 44361 | Biopsy of small bowel using an endoscope | 108 | $54.2K | $501.77 | 4.29x |
| 43242 | Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using an endoscope | 102 | $51.6K | $505.40 | 5.31x |
| 45381 | Injections of large bowel using an endoscope | 217 | $41.3K | $190.23 | 10.04x |
| 43259 | Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope | 73 | $38.4K | $526.54 | 5.05x |
| 43244 | Tying of dilated veins of stomach and/or esophagus using an endoscope | 36 | $18.4K | $510.14 | 4.38x |
| 45390 | Removal of large bowel tissue using an endoscope | 31 | $10.4K | $335.88 | 5.48x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 26 | $8.0K | $306.22 | 4.60x |
| 43202 | Biopsy of esophagus using an endoscope | 30 | $6.9K | $229.27 | 5.78x |
This provider submits charges 7.57 times higher than what Medicare actually pays.
A markup ratio of 7.57x means for every $100 Medicare pays, this provider initially charges $757. 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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