This provider's $5.5M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.29x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 3086% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1383% in 2019
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 |
|---|---|---|---|---|---|---|---|
| 2018 | $3.3K | $595.69 | 5.48x | $2.7K | $38.5K | 62 | 58 |
| 2019 | $6.9K | $1.3K | 5.49x | $5.7K | $571.3K | 584 | 543 |
| 2020 | $12.3K | $2.4K | 5.15x | $9.9K | $867.9K | 609 | 578 |
| 2021 | $14.8K | $3.1K | 4.82x | $11.7K | $1.3M | 655 | 611 |
| 2022 | $12.7K | $2.6K | 4.85x | $10.1K | $1.5M | 831 | 772 |
| 2023 | $9.9K | $1.7K | 5.65x | $8.1K | $1.2M | 779 | 726 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 63685 | Insertion of spinal neurostimulator pulse generator or receiver | 45 | $910.2K | $20.2K | 4.50x |
| 64721 | Release and/or relocation of median nerve of hand | 1.1K | $752.0K | $662.01 | 5.13x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 89 | $667.1K | $7.5K | 4.87x |
| 27447 | Repair of knee joint, lower or upper part of joint, inside and outside area | 87 | $644.6K | $7.4K | 5.47x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 261 | $536.3K | $2.1K | 5.80x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 110 | $405.7K | $3.7K | 5.19x |
| 26055 | Incision of tendon covering | 638 | $313.3K | $491.09 | 6.46x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 77 | $270.5K | $3.5K | 4.87x |
| 29880 | Removal of both knee cartilages using an endoscope | 143 | $156.2K | $1.1K | 5.09x |
| 29828 | Release of shoulder biceps tendon using an endoscope | 58 | $144.2K | $2.5K | 4.87x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 151 | $94.5K | $626.10 | 8.84x |
| 20680 | Removal of deep bone implant | 107 | $92.2K | $861.43 | 5.32x |
| 25447 | Removal of bone joints between wrist and fingers | 102 | $91.6K | $898.00 | 6.21x |
| 29881 | Removal of one knee cartilage using an endoscope | 81 | $87.0K | $1.1K | 5.17x |
| 49650 | Repair of groin hernia using an endoscope | 32 | $58.3K | $1.8K | 5.38x |
| 26160 | Removal of growth of tendon finger or hand | 86 | $47.2K | $548.58 | 5.80x |
| 25607 | Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware | 11 | $39.4K | $3.6K | 4.57x |
| 19318 | Breast reduction | 24 | $35.9K | $1.5K | 6.27x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 45 | $31.9K | $707.88 | 7.84x |
| 26123 | Removal of connective tissue of palm and release of finger, first digit | 27 | $30.6K | $1.1K | 4.98x |
This provider submits charges 5.29 times higher than what Medicare actually pays.
A markup ratio of 5.29x means for every $100 Medicare pays, this provider initially charges $529. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| West Suburban Eye Surgery Center Llc | Waltham, MA | $37.4M | ✓ Clear |
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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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