This provider's $8.1M in total Medicare payments ranks in the 96th 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 | $2.9K | $738.33 | 3.88x | $2.1K | $715.9K | 1.3K | 1.0K |
| 2015 | $2.7K | $696.02 | 3.88x | $2.0K | $732.4K | 1.3K | 991 |
| 2016 | $2.6K | $616.30 | 4.19x | $2.0K | $1.0M | 1.9K | 1.4K |
| 2017 | $2.7K | $617.40 | 4.39x | $2.1K | $910.1K | 1.7K | 1.3K |
| 2018 | $2.4K | $588.20 | 4.11x | $1.8K | $755.7K | 1.3K | 1.0K |
| 2019 | $2.2K | $664.04 | 3.33x | $1.6K | $763.4K | 1.5K | 1.1K |
| 2020 | $2.3K | $756.66 | 3.05x | $1.5K | $609.6K | 1.2K | 882 |
| 2021 | $1.8K | $513.80 | 3.47x | $1.3K | $753.8K | 1.7K | 1.2K |
| 2022 | $2.4K | $793.28 | 3.01x | $1.6K | $996.2K | 2.4K | 1.7K |
| 2023 | $2.3K | $824.33 | 2.83x | $1.5K | $806.7K | 1.7K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 6.1K | $4.4M | $727.70 | 5.49x |
| 0191T | Internal insertion of eye fluid drainage device | 437 | $758.6K | $1.7K | 1.55x |
| 66982 | Removal of cataract with insertion of lens | 642 | $471.4K | $734.21 | 5.52x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 1.2K | $429.5K | $370.55 | 1.89x |
| 66183 | Insertion of eye fluid drainage device | 192 | $301.0K | $1.6K | 1.79x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.4K | $236.6K | $171.56 | 6.83x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 97 | $231.6K | $2.4K | 1.81x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 2.4K | $188.1K | $78.96 | 2.52x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.6K | $162.2K | $98.66 | 6.77x |
| 67041 | Removal of membrane from the retina | 86 | $112.3K | $1.3K | 4.67x |
| 65820 | Incision to improve eye fluid flow | 79 | $105.8K | $1.3K | 2.61x |
| 66710 | Destruction of lens tissue using laser | 166 | $93.6K | $563.62 | 3.64x |
| 67904 | Repair of tendon of upper eyelid | 183 | $86.6K | $473.23 | 5.76x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 181 | $78.4K | $433.00 | 6.99x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 53 | $70.0K | $1.3K | 3.54x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 585 | $60.0K | $102.54 | 1.41x |
| 67042 | Removal of membrane from the retina, pars plana approach | 39 | $51.5K | $1.3K | 4.69x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 38 | $49.8K | $1.3K | 3.38x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 26 | $43.5K | $1.7K | 2.77x |
| 67900 | Repair of brow paralysis | 58 | $22.8K | $393.05 | 7.71x |
This provider submits charges 4.56 times higher than what Medicare actually pays.
A markup ratio of 4.56x means for every $100 Medicare pays, this provider initially charges $456. 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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