This provider's $3.3M in total Medicare payments ranks in the 98th percentile of Urology providers nationally.
Medicare payments to this provider grew 157% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 63% in 2022
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 | $607.93 | $179.48 | 3.39x | $428.45 | $257.3K | 4.5K | 2.4K |
| 2015 | $659.79 | $128.93 | 5.12x | $530.86 | $296.8K | 5.1K | 2.6K |
| 2016 | $794.68 | $163.60 | 4.86x | $631.08 | $244.8K | 4.2K | 2.3K |
| 2017 | $424.57 | $110.41 | 3.85x | $314.16 | $208.9K | 3.9K | 2.1K |
| 2018 | $535.61 | $109.15 | 4.91x | $426.46 | $218.3K | 4.0K | 2.0K |
| 2019 | $711.07 | $145.74 | 4.88x | $565.33 | $220.7K | 3.8K | 2.0K |
| 2020 | $576.28 | $115.43 | 4.99x | $460.85 | $239.8K | 3.9K | 2.0K |
| 2021 | $1.1K | $199.63 | 5.47x | $891.51 | $345.0K | 4.2K | 2.1K |
| 2022 | $832.89 | $148.25 | 5.62x | $684.64 | $562.0K | 11.1K | 4.9K |
| 2023 | $745.34 | $132.66 | 5.62x | $612.68 | $662.2K | 14.1K | 5.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.1K | $1.1M | $91.82 | 3.11x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 1.4K | $259.9K | $181.46 | 3.10x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.4K | $199.0K | $59.28 | 1.95x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.3K | $167.8K | $131.00 | 3.42x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 905 | $118.7K | $131.21 | 3.02x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 1.5K | $105.7K | $68.91 | 2.06x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 464 | $77.7K | $167.49 | 3.33x |
| 51729 | Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies | 222 | $70.1K | $315.94 | 3.09x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 2.0K | $68.7K | $34.43 | 2.52x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 2.0K | $68.7K | $34.43 | 2.52x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 2.0K | $68.7K | $34.43 | 2.51x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 2.0K | $68.7K | $34.43 | 2.51x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 2.0K | $68.7K | $34.45 | 2.51x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 2.0K | $68.6K | $34.43 | 2.52x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 2.0K | $68.6K | $34.45 | 2.52x |
| 76775 | Ultrasound behind abdominal cavity, limited | 1.3K | $65.9K | $50.88 | 5.39x |
| 50590 | Shock wave crushing of kidney stones | 114 | $55.7K | $488.53 | 5.65x |
| 52441 | Insertion of implant in bladder canal (urethra) within prostate gland using an endoscope, single implant | 42 | $53.0K | $1.3K | 5.23x |
| 81015 | Urinalysis using microscope | 14.5K | $51.0K | $3.52 | 5.68x |
| 55700 | Biopsy of prostate gland | 231 | $47.0K | $203.41 | 3.35x |
This provider submits charges 3.46 times higher than what Medicare actually pays.
A markup ratio of 3.46x means for every $100 Medicare pays, this provider initially charges $346. 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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