This provider's $13.4M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
82% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of lens).
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 | $1.1K | $285.77 | 3.77x | $791.31 | $1.3M | 3.3K | 1.5K |
| 2015 | $976.52 | $325.80 | 3.00x | $650.72 | $1.4M | 3.2K | 1.6K |
| 2016 | $1.3K | $393.75 | 3.28x | $897.16 | $1.6M | 2.9K | 1.8K |
| 2017 | $1.6K | $510.78 | 3.08x | $1.1K | $1.4M | 2.1K | 1.4K |
| 2018 | $2.3K | $784.80 | 2.87x | $1.5K | $1.5M | 2.1K | 1.4K |
| 2019 | $2.2K | $784.55 | 2.85x | $1.5K | $1.4M | 1.9K | 1.2K |
| 2020 | $3.2K | $1.3K | 2.50x | $1.9K | $843.9K | 1.0K | 617 |
| 2021 | $3.2K | $1.3K | 2.45x | $1.9K | $1.2M | 1.4K | 859 |
| 2022 | $2.6K | $1.1K | 2.44x | $1.5K | $1.4M | 1.6K | 993 |
| 2023 | $2.4K | $943.14 | 2.51x | $1.4K | $1.3M | 1.9K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 13.8K | $10.9M | $790.94 | 2.51x |
| 66982 | Removal of cataract with insertion of lens | 1.5K | $1.2M | $798.03 | 2.55x |
| 0191T | Internal insertion of eye fluid drainage device | 180 | $389.7K | $2.2K | 2.51x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.7K | $302.5K | $177.24 | 3.92x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 119 | $300.8K | $2.5K | 1.37x |
| 65820 | Incision to improve eye fluid flow | 97 | $78.3K | $806.99 | 4.72x |
| 67028 | Injection of drug into eye | 1.5K | $54.8K | $35.59 | 11.23x |
| 66174 | Dilation to improve eye fluid flow | 35 | $45.7K | $1.3K | 3.03x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 394 | $38.9K | $98.60 | 2.82x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 59 | $27.1K | $458.50 | 3.15x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 221 | $16.8K | $76.04 | 5.11x |
| 67904 | Repair of tendon of upper eyelid | 38 | $16.8K | $441.82 | 4.65x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 90 | $10.4K | $115.29 | 7.81x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 33 | $6.1K | $184.28 | 6.05x |
| 67908 | Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis | 12 | $6.0K | $502.85 | 4.09x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 23 | $4.2K | $184.74 | 6.50x |
| C9257 | Injection, bevacizumab, 0.25 mg | 1.5K | $1.8K | $1.23 | 122.15x |
This provider submits charges 2.6 times higher than what Medicare actually pays.
A markup ratio of 2.6x means for every $100 Medicare pays, this provider initially charges $260. 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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