This provider's $3.9M in total Medicare payments ranks in the 92th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.23x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 278% from 2021 to 2023.
61% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of lens, simple).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 248% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $2.5K | $450.15 | 5.63x | $2.1K | $476.0K | 742 | 519 |
| 2022 | $4.0K | $801.60 | 4.95x | $3.2K | $1.7M | 2.3K | 1.7K |
| 2023 | $4.0K | $794.42 | 5.01x | $3.2K | $1.8M | 2.7K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens, simple | 3.1K | $2.4M | $772.02 | 5.23x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 115 | $275.1K | $2.4K | 5.41x |
| 45385 | Removal of polyps or growths in large bowel using an endoscope (colonoscopy) using a mechanical snare | 670 | $274.3K | $409.45 | 4.99x |
| V2785 | Processing, preserving and transporting corneal tissue | 54 | $206.0K | $3.8K | 2.64x |
| 45380 | Biopsy of the large bowel using an endoscope (colonoscopy) | 466 | $150.2K | $322.34 | 6.35x |
| 66982 | Removal of cataract with insertion of lens, complex | 159 | $121.2K | $762.02 | 5.28x |
| 65756 | Transplantation of outer layer of corneal tissue | 54 | $76.8K | $1.4K | 5.12x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 191 | $70.4K | $368.41 | 4.24x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 313 | $69.8K | $223.04 | 7.68x |
| 65820 | Incision to improve eye fluid flow | 44 | $60.7K | $1.4K | 5.27x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 123 | $56.9K | $462.86 | 7.31x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 141 | $52.8K | $374.40 | 4.14x |
| 15822 | Removal of excessive skin of upper eyelid | 58 | $27.5K | $473.68 | 7.12x |
| 43249 | Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | 45 | $23.2K | $516.36 | 5.21x |
| 67900 | Repair of brow paralysis | 44 | $19.3K | $439.32 | 7.57x |
| 43248 | Insertion of guide wire with dilation of esophagus using a flexible endoscope | 58 | $15.8K | $273.23 | 5.83x |
| 67904 | Repair of tendon of upper eyelid | 33 | $15.7K | $476.48 | 6.98x |
| 66986 | Exchange of prosthetic lens | 15 | $12.0K | $797.37 | 4.91x |
| 45381 | Injection beneath lining of large bowel using a flexible endoscope | 55 | $11.8K | $213.89 | 9.54x |
| 66710 | Destruction of lens tissue using laser | 12 | $7.8K | $650.31 | 5.12x |
This provider submits charges 5.23 times higher than what Medicare actually pays.
A markup ratio of 5.23x means for every $100 Medicare pays, this provider initially charges $523. 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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