This provider's $5.9M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.32x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 112% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 108% in 2023
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 | $2.3K | $458.52 | 5.10x | $1.9K | $584.5K | 1.2K | 880 |
| 2015 | $2.3K | $424.15 | 5.54x | $1.9K | $539.4K | 1.3K | 961 |
| 2016 | $2.7K | $520.30 | 5.14x | $2.2K | $427.5K | 814 | 671 |
| 2017 | $2.9K | $530.18 | 5.50x | $2.4K | $448.7K | 812 | 671 |
| 2018 | $3.0K | $587.90 | 5.03x | $2.4K | $447.5K | 829 | 689 |
| 2019 | $2.7K | $521.23 | 5.11x | $2.1K | $439.3K | 908 | 732 |
| 2020 | $4.2K | $885.51 | 4.76x | $3.3K | $609.0K | 813 | 684 |
| 2021 | $4.2K | $815.64 | 5.11x | $3.4K | $613.3K | 901 | 717 |
| 2022 | $4.1K | $799.65 | 5.07x | $3.3K | $596.2K | 905 | 770 |
| 2023 | $6.3K | $1.3K | 5.05x | $5.1K | $1.2M | 1.1K | 869 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 2.8K | $2.0M | $739.96 | 5.56x |
| 27447 | Repair of knee joint | 217 | $1.4M | $6.4K | 4.71x |
| 29881 | Removal of one knee cartilage using an endoscope | 347 | $310.2K | $893.85 | 3.94x |
| 64721 | Release and/or relocation of median nerve of hand | 417 | $238.0K | $570.71 | 4.38x |
| 29880 | Removal of both knee cartilages using an endoscope | 216 | $197.0K | $912.24 | 3.86x |
| 45380 | Biopsy of large bowel using an endoscope | 591 | $176.0K | $297.81 | 7.72x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 697 | $164.0K | $235.28 | 9.78x |
| 23412 | Repair of torn tendons of shoulder, open procedure | 82 | $152.5K | $1.9K | 2.69x |
| 66982 | Removal of cataract with insertion of lens | 187 | $137.5K | $735.23 | 5.60x |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 20 | $137.1K | $6.9K | 5.11x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 528 | $136.4K | $258.30 | 5.81x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 331 | $118.4K | $357.76 | 6.43x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 189 | $114.8K | $607.27 | 2.79x |
| 26055 | Incision of tendon covering | 209 | $86.7K | $414.80 | 6.03x |
| 64718 | Release and/or relocation of ulnar nerve at elbow | 252 | $82.1K | $325.98 | 7.67x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 236 | $58.8K | $249.07 | 9.23x |
| 23120 | Partial removal of collar bone | 94 | $51.3K | $546.22 | 6.56x |
| 23130 | Removal or repair of collar bone and shoulder blade joint | 66 | $45.8K | $694.25 | 5.16x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 543 | $44.4K | $81.70 | 3.09x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 121 | $44.1K | $364.18 | 2.75x |
This provider submits charges 5.32 times higher than what Medicare actually pays.
A markup ratio of 5.32x means for every $100 Medicare pays, this provider initially charges $532. 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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