This provider's $12.5M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 9.45x is significantly above the specialty median of 6.1x.
65% 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 | $5.1K | $419.21 | 12.15x | $4.7K | $1.0M | 2.0K | 1.5K |
| 2015 | $5.5K | $499.19 | 11.01x | $5.0K | $1.1M | 2.2K | 1.6K |
| 2016 | $5.5K | $512.99 | 10.66x | $5.0K | $1.3M | 2.5K | 1.8K |
| 2017 | $6.4K | $650.45 | 9.77x | $5.7K | $1.2M | 2.1K | 1.5K |
| 2018 | $5.9K | $596.16 | 9.90x | $5.3K | $1.1M | 2.0K | 1.4K |
| 2019 | $5.2K | $525.88 | 9.85x | $4.7K | $1.4M | 3.0K | 2.0K |
| 2020 | $5.2K | $628.57 | 8.34x | $4.6K | $983.1K | 2.2K | 1.5K |
| 2021 | $5.7K | $678.44 | 8.35x | $5.0K | $1.3M | 3.2K | 2.1K |
| 2022 | $6.4K | $810.41 | 7.95x | $5.6K | $1.6M | 4.3K | 2.6K |
| 2023 | $7.1K | $839.27 | 8.43x | $6.2K | $1.5M | 3.2K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 10.7K | $7.9M | $739.41 | 8.72x |
| 0191T | Internal insertion of eye fluid drainage device | 419 | $829.9K | $2.0K | 6.01x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.3K | $429.7K | $183.46 | 7.56x |
| 66982 | Removal of cataract with insertion of lens | 511 | $364.9K | $714.11 | 8.89x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 3.4K | $354.4K | $104.33 | 6.91x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 919 | $331.3K | $360.53 | 1.69x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3.7K | $293.6K | $79.71 | 26.35x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 117 | $290.7K | $2.5K | 6.48x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 1.3K | $290.3K | $227.11 | 23.65x |
| 62311 | Injections of substances into lower or sacral spine | 691 | $180.4K | $261.01 | 20.19x |
| 66183 | Insertion of eye fluid drainage device | 132 | $178.7K | $1.4K | 8.58x |
| 67042 | Removal of membrane from the retina, pars plana approach with removal of internal limiting membrane of retina | 110 | $163.2K | $1.5K | 6.39x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 695 | $142.8K | $205.51 | 26.57x |
| 69436 | Incision of eardrum with insertion of eardrum tube under general anesthesia | 227 | $92.0K | $405.17 | 10.76x |
| 65820 | Incision to improve eye fluid flow | 63 | $86.8K | $1.4K | 7.16x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 457 | $62.2K | $136.10 | 10.12x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 40 | $60.0K | $1.5K | 7.09x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 123 | $57.3K | $466.02 | 15.42x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 208 | $54.0K | $259.49 | 20.76x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 71 | $40.7K | $573.34 | 9.84x |
This provider submits charges 9.45 times higher than what Medicare actually pays.
A markup ratio of 9.45x means for every $100 Medicare pays, this provider initially charges $945. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Main Line Surgery Center, Llc | Bala Cynwyd, PA | $38.7M | ✓ 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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