This provider's $21.8M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
71% 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 | $1.6K | $722.87 | 2.26x | $913.04 | $2.5M | 3.5K | 2.7K |
| 2015 | $1.7K | $708.06 | 2.34x | $949.83 | $2.6M | 3.6K | 2.8K |
| 2016 | $1.8K | $710.84 | 2.55x | $1.1K | $2.4M | 3.5K | 2.7K |
| 2017 | $1.7K | $684.21 | 2.47x | $1.0K | $2.5M | 3.4K | 2.6K |
| 2018 | $1.9K | $877.20 | 2.21x | $1.1K | $2.6M | 3.4K | 2.5K |
| 2019 | $1.8K | $804.90 | 2.26x | $1.0K | $2.3M | 3.1K | 2.3K |
| 2020 | $1.9K | $912.03 | 2.09x | $996.54 | $1.4M | 1.8K | 1.2K |
| 2021 | $1.9K | $1.0K | 1.86x | $871.03 | $1.7M | 2.0K | 1.4K |
| 2022 | $1.8K | $1.0K | 1.80x | $811.27 | $1.7M | 2.1K | 1.4K |
| 2023 | $1.7K | $787.07 | 2.11x | $876.48 | $2.1M | 2.5K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 19.3K | $15.1M | $778.99 | 1.93x |
| 66982 | Removal of cataract with insertion of lens | 1.6K | $1.2M | $769.33 | 1.95x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 545 | $671.6K | $1.2K | 1.83x |
| 67041 | Removal of membrane from the retina | 450 | $562.3K | $1.2K | 2.40x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.1K | $412.0K | $191.90 | 3.52x |
| 65820 | Incision to improve eye fluid flow | 335 | $386.3K | $1.2K | 2.10x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 277 | $380.1K | $1.4K | 1.82x |
| 67042 | Removal of membrane from the retina, pars plana approach | 266 | $364.0K | $1.4K | 2.19x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 219 | $295.5K | $1.3K | 1.85x |
| 66174 | Dilation to improve eye fluid flow | 192 | $281.6K | $1.5K | 1.48x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 148 | $269.3K | $1.8K | 1.65x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 159 | $212.2K | $1.3K | 2.25x |
| 67904 | Repair of tendon of upper eyelid | 358 | $178.1K | $497.50 | 2.71x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 435 | $172.0K | $395.42 | 2.92x |
| 66183 | Insertion of eye fluid drainage device | 78 | $157.7K | $2.0K | 1.72x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 289 | $128.5K | $444.47 | 3.37x |
| 66180 | Creation of shunt to improve eye fluid flow | 85 | $113.3K | $1.3K | 1.50x |
| 67121 | Removal of implant material from inside the eye | 119 | $108.4K | $911.33 | 3.29x |
| 0191T | Internal insertion of eye fluid drainage device | 65 | $105.0K | $1.6K | 1.45x |
| 66710 | Destruction of lens tissue using laser | 161 | $102.7K | $637.85 | 2.23x |
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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