This provider's $6.9M in total Medicare payments ranks in the 95th percentile of Ambulatory Surgical Center providers nationally.
62% 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.
Notable: Payments increased 81% in 2021
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 | $868.53 | $554.48 | 1.57x | $314.05 | $706.1K | 1.1K | 790 |
| 2015 | $798.75 | $475.25 | 1.68x | $323.50 | $745.8K | 1.2K | 882 |
| 2016 | $883.83 | $503.54 | 1.76x | $380.29 | $767.3K | 1.2K | 881 |
| 2017 | $928.44 | $498.02 | 1.86x | $430.42 | $688.4K | 1.2K | 836 |
| 2018 | $751.59 | $458.39 | 1.64x | $293.20 | $732.1K | 1.2K | 843 |
| 2019 | $1.0K | $574.74 | 1.78x | $448.17 | $551.3K | 870 | 634 |
| 2020 | $981.35 | $503.12 | 1.95x | $478.23 | $396.1K | 614 | 461 |
| 2021 | $1.3K | $642.63 | 1.99x | $634.50 | $718.7K | 951 | 669 |
| 2022 | $1.1K | $566.92 | 1.92x | $524.19 | $665.0K | 890 | 640 |
| 2023 | $1.9K | $1.0K | 1.89x | $906.39 | $918.5K | 1.1K | 808 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 4.9K | $4.2M | $864.27 | 1.54x |
| 66982 | Removal of cataract with insertion of lens | 2.0K | $1.7M | $872.76 | 1.59x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.5K | $538.3K | $213.01 | 1.73x |
| 67904 | Repair of tendon of upper eyelid | 175 | $95.0K | $542.58 | 2.08x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 123 | $74.2K | $603.07 | 1.62x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 20 | $59.7K | $3.0K | 1.65x |
| 65875 | Removal of scar tissue in eye | 130 | $58.6K | $450.86 | 2.73x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 335 | $46.9K | $140.08 | 2.45x |
| 65820 | Incision to improve eye fluid flow | 20 | $23.3K | $1.2K | 2.50x |
| 67966 | Removal of over one-fourth of the eyelid involving lid margin | 28 | $16.0K | $571.38 | 1.74x |
| 14040 | Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 13 | $7.8K | $599.40 | 1.74x |
| 11642 | Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips | 32 | $2.3K | $72.44 | 2.79x |
This provider submits charges 1.6 times higher than what Medicare actually pays.
A markup ratio of 1.6x means for every $100 Medicare pays, this provider initially charges $160. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| West Suburban Eye Surgery Center Llc | Waltham, MA | $37.4M | ✓ Clear |
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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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