This provider's $24.3M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
85% 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 | $1.5K | $563.10 | 2.68x | $945.47 | $2.3M | 3.3K | 2.5K |
| 2015 | $1.5K | $556.13 | 2.64x | $913.89 | $2.3M | 3.3K | 2.5K |
| 2016 | $1.4K | $556.92 | 2.59x | $886.72 | $2.6M | 3.7K | 2.7K |
| 2017 | $1.4K | $589.97 | 2.40x | $828.00 | $2.5M | 3.6K | 2.6K |
| 2018 | $1.5K | $660.28 | 2.34x | $882.22 | $2.6M | 3.6K | 2.6K |
| 2019 | $1.4K | $603.84 | 2.38x | $831.16 | $2.5M | 3.4K | 2.5K |
| 2020 | $1.7K | $821.83 | 2.07x | $877.92 | $1.9M | 2.3K | 1.7K |
| 2021 | $1.6K | $707.71 | 2.30x | $917.26 | $2.6M | 3.1K | 2.2K |
| 2022 | $1.8K | $767.87 | 2.36x | $1.0K | $2.6M | 3.1K | 2.2K |
| 2023 | $1.9K | $796.80 | 2.37x | $1.1K | $2.5M | 2.9K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 25.2K | $20.6M | $817.89 | 2.38x |
| 66982 | Removal of cataract with insertion of lens | 1.9K | $1.5M | $811.99 | 2.40x |
| 0191T | Internal insertion of eye fluid drainage device | 355 | $737.6K | $2.1K | 1.45x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.5K | $517.3K | $203.75 | 4.17x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 117 | $311.6K | $2.7K | 2.03x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 987 | $121.0K | $122.58 | 6.95x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 221 | $108.0K | $488.80 | 3.16x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 56 | $90.4K | $1.6K | 2.11x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 193 | $80.9K | $419.42 | 3.14x |
| 67904 | Repair of tendon of upper eyelid | 113 | $56.2K | $497.21 | 2.65x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 299 | $45.6K | $152.52 | 5.57x |
| 66174 | Dilation to improve eye fluid flow | 36 | $43.4K | $1.2K | 2.04x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 94 | $34.5K | $366.49 | 1.64x |
| 65820 | Incision to improve eye fluid flow | 16 | $17.4K | $1.1K | 2.23x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 180 | $14.3K | $79.28 | 1.89x |
| 67924 | Repair of turning-inward eyelid defect | 11 | $6.4K | $578.92 | 3.04x |
| 67917 | Extensive repair of turning-outward eyelid defect | 11 | $5.9K | $534.46 | 2.47x |
This provider submits charges 2.42 times higher than what Medicare actually pays.
A markup ratio of 2.42x means for every $100 Medicare pays, this provider initially charges $242. This is higher 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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