This provider's $22.1M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
68% 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 | $2.2K | $522.22 | 4.21x | $1.7K | $1.8M | 3.4K | 2.2K |
| 2015 | $2.5K | $580.77 | 4.28x | $1.9K | $1.9M | 3.6K | 2.4K |
| 2016 | $2.4K | $559.50 | 4.23x | $1.8K | $2.1M | 3.9K | 2.6K |
| 2017 | $2.7K | $664.84 | 4.11x | $2.1K | $2.4M | 4.2K | 2.7K |
| 2018 | $3.1K | $789.43 | 3.88x | $2.3K | $2.4M | 4.1K | 2.6K |
| 2019 | $3.2K | $844.46 | 3.75x | $2.3K | $2.4M | 4.1K | 2.6K |
| 2020 | $3.5K | $991.95 | 3.51x | $2.5K | $2.0M | 3.3K | 2.1K |
| 2021 | $2.8K | $982.87 | 2.85x | $1.8K | $2.4M | 3.8K | 2.4K |
| 2022 | $3.5K | $1.1K | 3.17x | $2.4K | $2.4M | 3.6K | 2.3K |
| 2023 | $3.5K | $1.1K | 3.07x | $2.3K | $2.4M | 3.6K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 20.3K | $14.9M | $736.90 | 3.93x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 9.7K | $1.8M | $186.62 | 5.01x |
| 0191T | Internal insertion of eye fluid drainage device | 667 | $1.2M | $1.8K | 2.77x |
| 66982 | Removal of cataract with insertion of lens | 1.6K | $1.2M | $724.74 | 3.99x |
| 65820 | Incision to improve eye fluid flow | 456 | $632.9K | $1.4K | 3.60x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 828 | $375.1K | $453.05 | 5.71x |
| V2785 | Processing, preserving and transporting corneal tissue | 62 | $220.5K | $3.6K | 1.27x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 81 | $201.8K | $2.5K | 3.75x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.6K | $177.1K | $110.36 | 7.94x |
| 67042 | Removal of membrane from the retina, pars plana approach | 123 | $165.2K | $1.3K | 3.70x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 99 | $134.3K | $1.4K | 3.66x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 78 | $134.0K | $1.7K | 2.85x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 59 | $123.3K | $2.1K | 3.40x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 62 | $113.4K | $1.8K | 3.42x |
| 65756 | Transplant of outer layer of corneal tissue | 65 | $96.7K | $1.5K | 3.09x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 606 | $82.8K | $136.67 | 5.10x |
| 67041 | Removal of membrane from the retina | 61 | $81.4K | $1.3K | 3.72x |
| 66710 | Destruction of lens tissue using laser | 121 | $74.5K | $615.98 | 3.01x |
| 67904 | Repair of tendon of upper eyelid | 126 | $59.8K | $474.48 | 5.02x |
| 67924 | Repair of turning-inward eyelid defect | 102 | $59.6K | $584.03 | 4.08x |
This provider submits charges 3.98 times higher than what Medicare actually pays.
A markup ratio of 3.98x means for every $100 Medicare pays, this provider initially charges $398. 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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