This provider's $14.5M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.09x is significantly above the specialty median of 6.1x.
64% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of lens).
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 | $3.2K | $524.45 | 6.11x | $2.7K | $1.3M | 2.3K | 1.9K |
| 2015 | $3.1K | $518.31 | 6.06x | $2.6K | $1.2M | 2.1K | 1.6K |
| 2016 | $3.0K | $550.66 | 5.46x | $2.5K | $1.2M | 2.0K | 1.5K |
| 2017 | $3.1K | $570.74 | 5.40x | $2.5K | $1.2M | 1.8K | 1.2K |
| 2018 | $4.1K | $843.81 | 4.90x | $3.3K | $1.5M | 2.1K | 1.5K |
| 2019 | $3.0K | $596.27 | 5.00x | $2.4K | $1.7M | 3.1K | 2.2K |
| 2020 | $4.3K | $924.90 | 4.63x | $3.4K | $1.3M | 2.7K | 1.9K |
| 2021 | $6.1K | $1.2K | 5.23x | $5.0K | $1.9M | 3.6K | 2.5K |
| 2022 | $5.8K | $941.59 | 6.18x | $4.9K | $1.8M | 3.6K | 2.7K |
| 2023 | $4.6K | $649.85 | 7.00x | $3.9K | $1.4M | 2.9K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 11.1K | $8.5M | $767.35 | 4.90x |
| 66982 | Removal of cataract with insertion of lens | 742 | $571.5K | $770.27 | 5.89x |
| 67042 | Removal of membrane from the retina, pars plana approach | 367 | $516.6K | $1.4K | 2.45x |
| 27447 | Repair of knee joint | 73 | $491.7K | $6.7K | 4.14x |
| 29881 | Removal of one knee cartilage using an endoscope | 324 | $314.9K | $971.77 | 4.86x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 770 | $286.4K | $371.89 | 5.57x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 200 | $284.7K | $1.4K | 6.28x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3.5K | $279.7K | $80.31 | 3.70x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 747 | $267.5K | $358.16 | 2.60x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 1.2K | $252.7K | $217.51 | 8.63x |
| 45380 | Biopsy of large bowel using an endoscope | 789 | $234.3K | $297.01 | 7.45x |
| 67041 | Removal of membrane from the retina | 153 | $223.7K | $1.5K | 3.70x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2.1K | $223.1K | $106.98 | 2.28x |
| 65820 | Incision to improve eye fluid flow | 141 | $205.9K | $1.5K | 6.17x |
| 45384 | Removal of polyps or growths in large bowel using an endoscope | 579 | $156.8K | $270.87 | 6.74x |
| 19301 | Partial removal of breast | 248 | $156.1K | $629.31 | 8.54x |
| 23412 | Repair of torn tendons of shoulder, open procedure | 71 | $121.3K | $1.7K | 4.06x |
| 38500 | Biopsy or removal of lymph nodes, open procedure | 142 | $121.0K | $851.79 | 5.79x |
| 64721 | Release and/or relocation of median nerve of hand | 180 | $106.8K | $593.19 | 3.80x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 245 | $86.1K | $351.24 | 6.92x |
This provider submits charges 5.09 times higher than what Medicare actually pays.
A markup ratio of 5.09x means for every $100 Medicare pays, this provider initially charges $509. 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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