This provider's $15.2M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
63% 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 | $1.9K | $695.75 | 2.79x | $1.2K | $1.2M | 2.2K | 1.6K |
| 2015 | $1.9K | $656.61 | 2.82x | $1.2K | $1.3M | 2.3K | 1.7K |
| 2016 | $1.8K | $639.28 | 2.80x | $1.2K | $1.5M | 2.7K | 2.0K |
| 2017 | $1.9K | $611.60 | 3.10x | $1.3K | $1.6M | 2.8K | 2.1K |
| 2018 | $3.4K | $663.91 | 5.14x | $2.7K | $1.6M | 2.7K | 2.0K |
| 2019 | $3.1K | $605.99 | 5.19x | $2.5K | $1.6M | 3.2K | 2.3K |
| 2020 | $3.3K | $735.69 | 4.47x | $2.6K | $1.4M | 2.8K | 2.0K |
| 2021 | $3.4K | $782.16 | 4.30x | $2.6K | $1.5M | 3.1K | 2.2K |
| 2022 | $4.2K | $1.0K | 4.10x | $3.2K | $1.7M | 3.2K | 2.2K |
| 2023 | $3.9K | $1.0K | 3.79x | $2.9K | $1.8M | 3.5K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 11.7K | $9.3M | $795.31 | 3.98x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 5.8K | $1.2M | $197.88 | 7.68x |
| V2785 | Processing, preserving and transporting corneal tissue | 315 | $1.1M | $3.5K | 1.28x |
| 66982 | Removal of cataract with insertion of lens | 908 | $704.1K | $775.41 | 4.79x |
| 65756 | Transplant of outer layer of corneal tissue | 271 | $386.8K | $1.4K | 3.72x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4.0K | $318.3K | $79.75 | 4.01x |
| 67950 | Enlargement of eyelid margin | 536 | $287.4K | $536.19 | 5.85x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 688 | $249.4K | $362.45 | 3.06x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 399 | $191.5K | $480.06 | 4.97x |
| 0191T | Internal insertion of eye fluid drainage device | 82 | $181.8K | $2.2K | 1.80x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 69 | $178.5K | $2.6K | 2.51x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.3K | $158.0K | $121.54 | 12.03x |
| 67903 | Shortening or advancement of upper eyelid muscle to correct drooping or paralysis | 303 | $156.4K | $516.07 | 6.77x |
| 65820 | Incision to improve eye fluid flow | 69 | $105.8K | $1.5K | 2.28x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 566 | $80.5K | $142.16 | 10.30x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 38 | $78.3K | $2.1K | 2.43x |
| 67921 | Suture repair of turning-inward eyelid defect | 205 | $70.5K | $343.80 | 6.83x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 45 | $69.5K | $1.5K | 4.67x |
| 67904 | Repair of tendon of upper eyelid | 124 | $66.0K | $532.60 | 5.80x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 127 | $65.3K | $513.98 | 8.56x |
This provider submits charges 4.28 times higher than what Medicare actually pays.
A markup ratio of 4.28x means for every $100 Medicare pays, this provider initially charges $428. 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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