This provider's $30.1M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.02x is significantly above the specialty median of 6.1x.
61% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of prosthetic 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 | $3.6K | $569.13 | 6.38x | $3.1K | $2.6M | 4.6K | 20 |
| 2015 | $4.0K | $574.17 | 6.98x | $3.4K | $2.8M | 4.8K | 19 |
| 2016 | $5.0K | $603.98 | 8.28x | $4.4K | $3.1M | 5.2K | 23 |
| 2017 | $5.0K | $609.78 | 8.15x | $4.4K | $3.2M | 5.3K | 23 |
| 2018 | $4.2K | $614.40 | 6.87x | $3.6K | $3.2M | 5.3K | 23 |
| 2019 | $4.0K | $616.37 | 6.56x | $3.4K | $3.3M | 5.4K | 22 |
| 2020 | $4.2K | $647.08 | 6.44x | $3.5K | $2.8M | 4.3K | 22 |
| 2021 | $1.1K | $184.65 | 6.01x | $924.83 | $3.1M | 16.7K | 22 |
| 2022 | $1.7K | $240.19 | 7.25x | $1.5K | $2.7M | 11.1K | 22 |
| 2023 | $1.5K | $203.82 | 7.14x | $1.3K | $3.2M | 15.7K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 22.9K | $17.7M | $773.98 | 6.22x |
| 0191T | Internal insertion of eye fluid drainage device | 854 | $1.6M | $1.9K | 3.46x |
| 45380 | Biopsy of large bowel using a flexible endoscope | 5.2K | $1.5M | $297.35 | 12.57x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 4.0K | $1.5M | $379.43 | 9.46x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 592 | $1.2M | $2.1K | 5.17x |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 5.2K | $1.2M | $231.09 | 12.35x |
| 64590 | Insertion of peripheral or gastric neurostimulator generator | 54 | $731.6K | $13.5K | 1.64x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 855 | $648.3K | $758.26 | 4.55x |
| 65820 | Incision to improve eye fluid flow | 315 | $465.2K | $1.5K | 3.77x |
| 45378 | Diagnostic exam of large bowel using a flexible endoscope | 1.5K | $435.2K | $283.92 | 12.64x |
| 64721 | Release and/or relocation of hand nerve | 630 | $365.0K | $579.36 | 14.50x |
| 29823 | Removal of extensive shoulder joint tissue using an endoscope | 457 | $297.5K | $650.90 | 9.47x |
| 26055 | Incision of tendon covering of finger | 554 | $250.8K | $452.75 | 9.33x |
| 45384 | Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery | 852 | $236.6K | $277.72 | 13.69x |
| 25447 | Removal of bone joints between wrist and fingers | 207 | $166.0K | $802.16 | 11.11x |
| 43249 | Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | 319 | $157.3K | $493.22 | 4.91x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 445 | $154.8K | $347.89 | 11.01x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 296 | $139.3K | $470.71 | 6.94x |
| 28285 | Correction of toe joint deformity | 179 | $110.6K | $618.07 | 11.62x |
| 29881 | Removal of knee cartilage using an endoscope | 110 | $108.0K | $981.69 | 13.67x |
This provider submits charges 7.02 times higher than what Medicare actually pays.
A markup ratio of 7.02x means for every $100 Medicare pays, this provider initially charges $702. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Roanoke Valley Center For Sight Llc | Salem, VA | $57.7M | ✓ Clear |
| Stony Point Surgery Center, L.L.C | Richmond, VA | $45.5M | ✓ Clear |
| Virginia Eye Institute Inc | Richmond, VA | $40.0M | ✓ 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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