This provider's $5.8M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Medicare payments to this provider grew 72% from 2014 to 2023.
72% 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 61% 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 | $810.71 | $557.99 | 1.45x | $252.72 | $456.2K | 672 | 441 |
| 2015 | $871.76 | $594.52 | 1.47x | $277.24 | $423.9K | 631 | 420 |
| 2016 | $844.44 | $599.66 | 1.41x | $244.78 | $451.1K | 666 | 427 |
| 2017 | $760.84 | $553.92 | 1.37x | $206.92 | $439.7K | 667 | 426 |
| 2018 | $853.51 | $606.93 | 1.41x | $246.58 | $398.6K | 584 | 376 |
| 2019 | $953.04 | $678.71 | 1.40x | $274.33 | $551.8K | 982 | 644 |
| 2020 | $1.0K | $755.76 | 1.38x | $284.82 | $518.1K | 944 | 603 |
| 2021 | $1.1K | $815.85 | 1.39x | $315.75 | $834.8K | 1.6K | 935 |
| 2022 | $1.6K | $1.1K | 1.46x | $506.24 | $924.2K | 1.7K | 969 |
| 2023 | $1.1K | $795.60 | 1.41x | $326.63 | $783.2K | 1.5K | 911 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 5.9K | $4.1M | $696.70 | 1.35x |
| 0191T | Internal insertion of eye fluid drainage device | 212 | $418.5K | $2.0K | 1.31x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 145 | $332.1K | $2.3K | 1.45x |
| 66982 | Removal of cataract with insertion of lens | 322 | $222.4K | $690.81 | 1.35x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2.6K | $209.3K | $79.31 | 1.90x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 87 | $199.3K | $2.3K | 1.42x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 234 | $85.2K | $364.25 | 1.44x |
| 67041 | Removal of membrane from the retina | 68 | $77.1K | $1.1K | 1.28x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 143 | $62.1K | $434.35 | 1.82x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 28 | $27.2K | $970.20 | 1.33x |
| 67904 | Repair of tendon of upper eyelid | 28 | $12.6K | $449.36 | 1.62x |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 107 | $59.56 | $0.56 | 1.35x |
This provider submits charges 1.38 times higher than what Medicare actually pays.
A markup ratio of 1.38x means for every $100 Medicare pays, this provider initially charges $138. This is lower 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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