This provider's $24.6M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
71% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of prosthetic 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 | $2.0K | $643.97 | 3.06x | $1.3K | $2.4M | 3.8K | 16 |
| 2015 | $2.0K | $644.76 | 3.06x | $1.3K | $2.6M | 4.0K | 15 |
| 2016 | $2.7K | $669.09 | 4.11x | $2.1K | $2.4M | 3.6K | 16 |
| 2017 | $2.9K | $712.32 | 4.10x | $2.2K | $2.2M | 3.0K | 12 |
| 2018 | $3.0K | $744.71 | 4.03x | $2.3K | $2.1M | 2.8K | 11 |
| 2019 | $3.0K | $740.34 | 4.08x | $2.3K | $2.2M | 2.9K | 13 |
| 2020 | $3.2K | $833.66 | 3.81x | $2.3K | $2.1M | 2.5K | 14 |
| 2021 | $710.38 | $202.63 | 3.51x | $507.75 | $2.4M | 11.9K | 16 |
| 2022 | $41.98 | $12.23 | 3.43x | $29.75 | $3.2M | 260.9K | 16 |
| 2023 | $1.0K | $307.00 | 3.35x | $720.16 | $3.1M | 10.1K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 22.6K | $17.1M | $754.55 | 3.79x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 2.5K | $1.9M | $737.12 | 4.46x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 16.1K | $1.3M | $77.57 | 2.68x |
| 65820 | Incision to improve eye fluid flow | 342 | $475.3K | $1.4K | 2.06x |
| V2785 | Processing, preserving and transporting corneal tissue | 140 | $468.4K | $3.3K | 1.28x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 147 | $367.1K | $2.5K | 2.60x |
| 66174 | Dilation of fluid outflow drainage within eye | 266 | $341.7K | $1.3K | 2.43x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 206 | $281.7K | $1.4K | 2.05x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 596 | $277.0K | $464.75 | 3.54x |
| 67041 | Removal of membrane of retina | 214 | $273.6K | $1.3K | 2.12x |
| 65756 | Transplantation of outer layer of corneal tissue | 151 | $219.6K | $1.5K | 7.75x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 157 | $214.3K | $1.4K | 2.01x |
| J1095 | Injection, dexamethasone 9 percent, intraocular, 1 microgram | 258.0K | $180.0K | $0.70 | 3.18x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 879 | $160.0K | $182.07 | 2.75x |
| 67005 | Partial removal of eye fluid between lens and retina | 220 | $126.7K | $575.72 | 4.18x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 101 | $116.7K | $1.2K | 2.44x |
| 67904 | Repair of tendon of upper eyelid | 212 | $108.9K | $513.86 | 3.96x |
| 0191T | Internal insertion of eye fluid drainage device | 37 | $80.5K | $2.2K | 2.03x |
| 67924 | Extensive repair of turning-inward eyelid defect | 116 | $72.2K | $622.20 | 2.77x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 512 | $68.8K | $134.31 | 3.76x |
This provider submits charges 3.62 times higher than what Medicare actually pays.
A markup ratio of 3.62x means for every $100 Medicare pays, this provider initially charges $362. 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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