This provider's $10.0M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Medicare payments to this provider grew 440% from 2014 to 2023.
63% of their billing comes from a single procedure code (88121 — Cell examination of urine).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1224% in 2015
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 | $731.25 | $259.59 | 2.82x | $471.66 | $140.1K | 648 | 645 |
| 2015 | $411.04 | $166.32 | 2.47x | $244.72 | $1.9M | 8.9K | 7.2K |
| 2016 | $352.18 | $137.37 | 2.56x | $214.81 | $1.8M | 9.0K | 7.3K |
| 2017 | $371.04 | $138.31 | 2.68x | $232.73 | $1.2M | 6.6K | 5.5K |
| 2018 | $421.25 | $140.76 | 2.99x | $280.49 | $983.2K | 5.8K | 4.8K |
| 2019 | $455.25 | $142.69 | 3.19x | $312.56 | $887.0K | 5.7K | 4.8K |
| 2020 | $438.12 | $130.51 | 3.36x | $307.61 | $736.6K | 4.8K | 4.1K |
| 2021 | $538.33 | $151.24 | 3.56x | $387.09 | $700.3K | 4.5K | 3.7K |
| 2022 | $406.11 | $118.41 | 3.43x | $287.70 | $953.8K | 5.6K | 4.7K |
| 2023 | $502.14 | $138.45 | 3.63x | $363.69 | $756.6K | 4.3K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88121 | Cell examination of urine | 16.0K | $6.3M | $394.09 | 3.81x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens | 5.7K | $1.9M | $341.34 | 2.93x |
| 88112 | Cell examination of specimen | 31.3K | $1.6M | $50.70 | 4.44x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1.8K | $90.1K | $50.74 | 3.94x |
| 88344 | Special stained specimen slides to examine tissue | 232 | $28.2K | $121.41 | 1.72x |
| 88342 | Tissue or cell analysis by immunologic technique | 224 | $17.9K | $79.70 | 2.48x |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 71 | $15.6K | $220.35 | 1.36x |
| 88341 | Special stained specimen slides to examine tissue | 166 | $10.4K | $62.90 | 1.42x |
| 88300 | Pathology examination of tissue using a microscope, limited examination | 194 | $2.4K | $12.50 | 3.20x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 35 | $1.2K | $34.36 | 4.37x |
| 84153 | PSA (prostate specific antigen) measurement | 34 | $837.08 | $24.62 | 1.42x |
This provider submits charges 3.72 times higher than what Medicare actually pays.
A markup ratio of 3.72x means for every $100 Medicare pays, this provider initially charges $372. 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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