This provider's $12.3M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
64% 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 | $715.28 | 2.58x | $1.1K | $1.0M | 1.7K | 1.4K |
| 2015 | $1.8K | $711.34 | 2.59x | $1.1K | $1.1M | 1.9K | 1.5K |
| 2016 | $1.9K | $655.47 | 2.90x | $1.2K | $1.2M | 2.0K | 1.6K |
| 2017 | $2.2K | $918.14 | 2.44x | $1.3K | $1.1M | 1.9K | 1.5K |
| 2018 | $2.4K | $943.23 | 2.56x | $1.5K | $1.2M | 1.9K | 1.5K |
| 2019 | $2.3K | $885.83 | 2.56x | $1.4K | $1.2M | 2.0K | 1.6K |
| 2020 | $2.6K | $1.1K | 2.38x | $1.5K | $1.1M | 1.6K | 1.3K |
| 2021 | $2.6K | $996.47 | 2.58x | $1.6K | $1.5M | 2.1K | 1.6K |
| 2022 | $2.7K | $1.1K | 2.47x | $1.6K | $1.4M | 2.0K | 1.5K |
| 2023 | $2.8K | $1.1K | 2.49x | $1.7K | $1.5M | 1.9K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 10.4K | $7.6M | $732.13 | 2.99x |
| 0191T | Internal insertion of eye fluid drainage device | 385 | $698.9K | $1.8K | 2.31x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 3.7K | $652.4K | $176.47 | 4.10x |
| V2785 | Processing, preserving and transporting corneal tissue | 162 | $445.4K | $2.7K | 1.40x |
| 66982 | Removal of cataract with insertion of lens | 496 | $360.3K | $726.35 | 3.00x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 145 | $357.3K | $2.5K | 2.47x |
| 67042 | Removal of membrane from the retina, pars plana approach | 246 | $334.4K | $1.4K | 2.54x |
| 66180 | Creation of shunt to improve eye fluid flow | 171 | $270.9K | $1.6K | 2.22x |
| 65756 | Transplant of outer layer of corneal tissue | 113 | $158.5K | $1.4K | 2.37x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 113 | $156.6K | $1.4K | 2.53x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.3K | $131.4K | $102.44 | 5.24x |
| 67904 | Repair of tendon of upper eyelid | 257 | $120.3K | $467.98 | 3.76x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 75 | $107.0K | $1.4K | 2.50x |
| 67041 | Removal of membrane from the retina | 73 | $101.6K | $1.4K | 2.57x |
| 66174 | Dilation to improve eye fluid flow | 89 | $96.9K | $1.1K | 3.32x |
| 66183 | Insertion of eye fluid drainage device | 45 | $88.2K | $2.0K | 1.82x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 187 | $86.4K | $462.04 | 3.90x |
| 66250 | Revision or repair of operative wound of eye | 118 | $65.1K | $551.89 | 2.54x |
| 67917 | Extensive repair of turning-outward eyelid defect | 131 | $62.5K | $477.11 | 3.65x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 33 | $59.7K | $1.8K | 2.13x |
This provider submits charges 2.92 times higher than what Medicare actually pays.
A markup ratio of 2.92x means for every $100 Medicare pays, this provider initially charges $292. 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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