This provider's $5.9M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $2.4K | $1.1K | 2.12x | $1.3K | $446.7K | 362 | 353 |
| 2015 | $2.4K | $1.1K | 2.14x | $1.3K | $558.0K | 446 | 427 |
| 2016 | $2.4K | $939.47 | 2.53x | $1.4K | $553.7K | 480 | 464 |
| 2017 | $2.6K | $1.2K | 2.18x | $1.4K | $600.9K | 468 | 451 |
| 2018 | $2.5K | $1.2K | 2.08x | $1.3K | $654.6K | 505 | 488 |
| 2019 | $2.5K | $1.2K | 2.08x | $1.3K | $638.9K | 490 | 483 |
| 2020 | $2.6K | $1.3K | 2.03x | $1.3K | $627.1K | 457 | 442 |
| 2021 | $2.7K | $1.5K | 1.87x | $1.3K | $622.4K | 429 | 411 |
| 2022 | $2.5K | $1.3K | 1.95x | $1.2K | $630.2K | 441 | 426 |
| 2023 | $2.8K | $1.5K | 1.86x | $1.3K | $580.7K | 387 | 368 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67042 | Removal of membrane from the retina, pars plana approach | 1.7K | $2.3M | $1.4K | 2.22x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 883 | $1.2M | $1.4K | 1.82x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 748 | $987.6K | $1.3K | 1.62x |
| 67041 | Removal of membrane from the retina | 460 | $611.1K | $1.3K | 2.29x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 362 | $485.2K | $1.3K | 1.87x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 219 | $293.6K | $1.3K | 2.27x |
| 66820 | Removal of recurring cataract in lens capsule | 80 | $23.3K | $291.35 | 2.86x |
| 66986 | Exchange of lens prosthesis | 37 | $15.9K | $428.63 | 4.12x |
| 66985 | Insertion of prosthetic lens | 12 | $4.9K | $412.30 | 4.28x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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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