This provider's $15.8M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
65% 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 | $1.7K | $770.20 | 2.19x | $915.69 | $1.6M | 2.7K | 2.1K |
| 2015 | $1.6K | $685.06 | 2.29x | $885.77 | $1.5M | 2.7K | 2.1K |
| 2016 | $1.8K | $709.92 | 2.57x | $1.1K | $1.7M | 2.8K | 2.1K |
| 2017 | $1.8K | $817.71 | 2.23x | $1.0K | $1.6M | 2.8K | 2.1K |
| 2018 | $1.9K | $814.03 | 2.29x | $1.1K | $1.6M | 2.7K | 2.0K |
| 2019 | $2.0K | $1.0K | 1.99x | $993.89 | $1.9M | 2.8K | 2.0K |
| 2020 | $2.1K | $1.1K | 1.86x | $976.19 | $1.3M | 2.0K | 1.5K |
| 2021 | $2.5K | $1.2K | 2.16x | $1.4K | $1.6M | 2.1K | 1.5K |
| 2022 | $2.8K | $1.4K | 2.00x | $1.4K | $1.3M | 1.7K | 1.2K |
| 2023 | $2.2K | $1.1K | 2.00x | $1.1K | $1.6M | 2.0K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 12.9K | $10.1M | $784.29 | 3.50x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 6.0K | $987.2K | $165.23 | 6.07x |
| 66982 | Removal of cataract with insertion of lens | 1.0K | $791.1K | $773.34 | 3.54x |
| V2785 | Processing, preserving and transporting corneal tissue | 211 | $725.0K | $3.4K | 1.29x |
| 67042 | Removal of membrane from the retina, pars plana approach | 386 | $541.8K | $1.4K | 1.77x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 200 | $432.5K | $2.2K | 1.58x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 202 | $285.1K | $1.4K | 1.67x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 194 | $259.7K | $1.3K | 1.65x |
| 0191T | Internal insertion of eye fluid drainage device | 118 | $243.0K | $2.1K | 1.53x |
| 65756 | Transplant of outer layer of corneal tissue | 170 | $237.2K | $1.4K | 1.72x |
| 66170 | Creation of eye fluid drainage tract | 317 | $223.8K | $706.14 | 2.49x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 55 | $139.8K | $2.5K | 1.87x |
| 66172 | Creation of eye fluid drainage tract | 146 | $111.6K | $764.46 | 2.79x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 663 | $96.3K | $145.30 | 4.51x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 389 | $70.8K | $181.94 | 3.60x |
| 66180 | Creation of shunt to improve eye fluid flow | 51 | $65.3K | $1.3K | 1.33x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 141 | $60.8K | $431.11 | 3.80x |
| 67041 | Removal of membrane of retina | 34 | $51.7K | $1.5K | 2.51x |
| 66250 | Revision or repair of operative wound of eye | 58 | $35.3K | $609.43 | 1.60x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 292 | $34.8K | $119.16 | 5.50x |
This provider submits charges 3.29 times higher than what Medicare actually pays.
A markup ratio of 3.29x means for every $100 Medicare pays, this provider initially charges $329. 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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