This provider's $5.6M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.68x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 75% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 63% 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 | $3.5K | $683.82 | 5.13x | $2.8K | $401.3K | 598 | 490 |
| 2015 | $3.3K | $627.00 | 5.30x | $2.7K | $502.9K | 739 | 590 |
| 2016 | $3.8K | $726.13 | 5.24x | $3.1K | $554.3K | 777 | 597 |
| 2017 | $3.3K | $592.76 | 5.64x | $2.8K | $474.5K | 724 | 563 |
| 2018 | $3.5K | $608.22 | 5.76x | $2.9K | $588.8K | 885 | 663 |
| 2019 | $3.4K | $573.88 | 5.92x | $2.8K | $583.5K | 906 | 675 |
| 2020 | $3.5K | $754.24 | 4.68x | $2.8K | $410.7K | 571 | 441 |
| 2021 | $3.7K | $839.04 | 4.44x | $2.9K | $671.2K | 903 | 695 |
| 2022 | $3.7K | $853.13 | 4.34x | $2.8K | $706.5K | 910 | 670 |
| 2023 | $4.7K | $877.67 | 5.36x | $3.8K | $702.8K | 867 | 667 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 4.0K | $3.1M | $759.79 | 5.78x |
| 66982 | Removal of cataract with insertion of lens | 1.4K | $1.1M | $753.77 | 5.80x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 207 | $274.9K | $1.3K | 3.89x |
| 67042 | Removal of membrane from the retina, pars plana approach | 148 | $201.2K | $1.4K | 3.89x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 539 | $121.7K | $225.83 | 10.34x |
| 45380 | Biopsy of large bowel using an endoscope | 319 | $110.5K | $346.41 | 6.69x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 301 | $94.5K | $313.98 | 7.09x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 55 | $93.3K | $1.7K | 3.20x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 156 | $74.0K | $474.35 | 5.97x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 40 | $64.9K | $1.6K | 3.56x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 43 | $56.7K | $1.3K | 4.11x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 146 | $56.1K | $384.10 | 7.74x |
| 66174 | Dilation to improve eye fluid flow | 40 | $49.0K | $1.2K | 4.65x |
| 66183 | Insertion of eye fluid drainage device | 22 | $43.6K | $2.0K | 2.83x |
| 29848 | Release of wrist ligament using an endoscope | 81 | $40.4K | $498.43 | 7.81x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 112 | $40.0K | $357.32 | 6.60x |
| 66987 | Complex removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 20 | $37.0K | $1.8K | 2.70x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 11 | $19.1K | $1.7K | 5.23x |
| 65426 | Removal or relocation of corneal conjunctiva, with graft | 29 | $18.1K | $625.04 | 6.71x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 51 | $18.0K | $353.20 | 6.30x |
This provider submits charges 5.68 times higher than what Medicare actually pays.
A markup ratio of 5.68x means for every $100 Medicare pays, this provider initially charges $568. 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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