This provider's $19.4M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $1.2K | $820.23 | 1.45x | $367.95 | $1.9M | 2.6K | 2.0K |
| 2015 | $1.1K | $758.69 | 1.44x | $332.40 | $2.0M | 2.8K | 2.2K |
| 2016 | $1.1K | $741.53 | 1.44x | $324.98 | $1.7M | 2.3K | 1.8K |
| 2017 | $1.3K | $863.69 | 1.55x | $473.97 | $1.9M | 2.2K | 1.7K |
| 2018 | $1.5K | $980.37 | 1.48x | $473.69 | $2.1M | 2.3K | 1.8K |
| 2019 | $1.5K | $1.0K | 1.43x | $449.82 | $1.9M | 2.1K | 1.6K |
| 2020 | $1.5K | $982.69 | 1.49x | $480.97 | $1.6M | 1.8K | 1.4K |
| 2021 | $1.5K | $1.1K | 1.42x | $448.03 | $2.0M | 2.6K | 2.1K |
| 2022 | $1.8K | $1.3K | 1.45x | $567.43 | $2.2M | 3.0K | 2.4K |
| 2023 | $1.8K | $1.1K | 1.63x | $690.39 | $2.2M | 4.0K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 11.1K | $11.3M | $1.0K | 1.41x |
| 0191T | Internal insertion of eye fluid drainage device | 665 | $1.7M | $2.5K | 1.28x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 4.6K | $1.2M | $262.17 | 1.44x |
| 66982 | Removal of cataract with insertion of lens | 1.1K | $1.1M | $1.0K | 1.43x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 1.0K | $705.5K | $692.38 | 1.63x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 158 | $559.1K | $3.5K | 1.49x |
| 67904 | Repair of tendon of upper eyelid | 739 | $513.4K | $694.73 | 1.73x |
| 66180 | Creation of shunt to improve eye fluid flow | 196 | $324.0K | $1.7K | 1.58x |
| 65426 | Removal or relocation of corneal conjunctiva | 355 | $307.7K | $866.81 | 1.44x |
| 66225 | Removal of protrusion sclera or cornea with graft | 211 | $262.4K | $1.2K | 1.75x |
| 67917 | Extensive repair of turning-outward eyelid defect | 311 | $234.7K | $754.62 | 1.55x |
| 65820 | Incision to improve eye fluid flow | 104 | $209.7K | $2.0K | 1.37x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2.6K | $203.0K | $76.62 | 1.48x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.2K | $191.0K | $155.94 | 1.55x |
| 66183 | Insertion of eye fluid drainage device | 43 | $130.2K | $3.0K | 1.42x |
| 67924 | Repair of turning-inward eyelid defect | 143 | $117.8K | $823.71 | 1.37x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 350 | $66.5K | $190.07 | 1.60x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 16 | $57.5K | $3.6K | 1.28x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 508 | $50.1K | $98.72 | 1.86x |
| 67935 | Repair of wound of eyelid margin | 53 | $38.1K | $718.73 | 1.52x |
This provider submits charges 1.43 times higher than what Medicare actually pays.
A markup ratio of 1.43x means for every $100 Medicare pays, this provider initially charges $143. This is lower 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Specialty Surgical Center, Llc | Beverly Hills, CA | $49.2M | ✓ Clear |
| Santa Rosa Surgery Center L P | Santa Rosa, CA | $41.3M | ✓ Clear |
| Peninsula Eye Surgery Center Llc | Mountain View, CA | $37.0M | ✓ Clear |
| Fort Sutter Surgery Center A California Limited Partnership | Sacramento, CA | $33.6M | ✓ 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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