This provider's $12.0M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
70% 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 | $1.8K | $827.30 | 2.22x | $1.0K | $915.4K | 1.4K | 1.0K |
| 2015 | $1.9K | $816.30 | 2.32x | $1.1K | $963.5K | 1.5K | 1.1K |
| 2016 | $1.8K | $785.82 | 2.33x | $1.0K | $927.2K | 1.5K | 1.1K |
| 2017 | $1.8K | $731.97 | 2.43x | $1.0K | $1.1M | 1.8K | 1.3K |
| 2018 | $2.2K | $863.88 | 2.53x | $1.3K | $1.3M | 2.2K | 1.6K |
| 2019 | $2.0K | $745.30 | 2.66x | $1.2K | $1.5M | 2.9K | 2.0K |
| 2020 | $2.6K | $1.1K | 2.45x | $1.5K | $1.2M | 2.4K | 1.7K |
| 2021 | $2.3K | $823.79 | 2.80x | $1.5K | $1.6M | 3.5K | 2.3K |
| 2022 | $2.3K | $928.45 | 2.53x | $1.4K | $1.4M | 3.1K | 2.0K |
| 2023 | $1.9K | $739.41 | 2.52x | $1.1K | $1.3M | 2.8K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 11.9K | $8.4M | $705.12 | 3.00x |
| 66982 | Removal of cataract with insertion of lens | 1.0K | $726.7K | $698.04 | 3.07x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 1.2K | $441.2K | $363.13 | 2.61x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 5.1K | $406.8K | $79.46 | 2.98x |
| 0191T | Internal insertion of eye fluid drainage device | 176 | $336.6K | $1.9K | 2.39x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.7K | $277.4K | $158.95 | 3.83x |
| 66180 | Creation of shunt to improve eye fluid flow | 144 | $201.1K | $1.4K | 2.21x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 85 | $193.7K | $2.3K | 2.25x |
| V2785 | Processing, preserving and transporting corneal tissue | 76 | $182.2K | $2.4K | 1.30x |
| 67041 | Removal of membrane from the retina | 134 | $164.0K | $1.2K | 2.55x |
| 66172 | Creation of eye fluid drainage tract | 167 | $117.1K | $700.91 | 2.32x |
| 67042 | Removal of membrane from the retina, pars plana approach | 88 | $111.7K | $1.3K | 2.48x |
| 66170 | Creation of eye fluid drainage tract | 128 | $82.0K | $640.29 | 2.39x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 186 | $80.3K | $431.57 | 3.45x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 48 | $62.8K | $1.3K | 2.52x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 63 | $55.3K | $877.31 | 5.00x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 34 | $44.0K | $1.3K | 2.48x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 433 | $33.3K | $76.97 | 3.67x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 14 | $26.4K | $1.9K | 1.69x |
| 67904 | Repair of tendon of upper eyelid | 46 | $20.1K | $436.08 | 2.96x |
This provider submits charges 2.93 times higher than what Medicare actually pays.
A markup ratio of 2.93x means for every $100 Medicare pays, this provider initially charges $293. 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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