This provider's $22.5M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.26x is significantly above the specialty median of 6.1x.
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.
Notable: Payments increased 69% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $5.1K | $938.70 | 5.40x | $4.1K | $2.3M | 2.5K | 2.0K |
| 2015 | $5.6K | $1.2K | 4.87x | $4.5K | $2.3M | 2.4K | 1.9K |
| 2016 | $5.4K | $1.2K | 4.67x | $4.2K | $2.4M | 2.4K | 1.9K |
| 2017 | $5.1K | $1.3K | 3.99x | $3.8K | $2.2M | 2.1K | 1.6K |
| 2018 | $5.4K | $1.2K | 4.38x | $4.2K | $2.3M | 2.2K | 1.7K |
| 2019 | $5.3K | $1.2K | 4.37x | $4.1K | $2.2M | 2.1K | 1.6K |
| 2020 | $5.5K | $1.2K | 4.57x | $4.3K | $1.5M | 1.3K | 1.0K |
| 2021 | $5.3K | $1.2K | 4.44x | $4.1K | $2.5M | 2.1K | 1.6K |
| 2022 | $7.4K | $1.4K | 5.21x | $6.0K | $2.6M | 2.0K | 1.5K |
| 2023 | $8.4K | $1.5K | 5.57x | $6.9K | $2.1M | 1.6K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 13.4K | $13.9M | $1.0K | 5.43x |
| 0191T | Internal insertion of eye fluid drainage device | 740 | $1.8M | $2.5K | 3.97x |
| 66982 | Removal of cataract with insertion of lens | 1.6K | $1.7M | $1.0K | 5.45x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 180 | $658.0K | $3.7K | 6.37x |
| 65820 | Incision to improve eye fluid flow | 320 | $599.5K | $1.9K | 4.67x |
| 66180 | Creation of shunt to improve eye fluid flow | 258 | $594.3K | $2.3K | 4.24x |
| 66174 | Dilation to improve eye fluid flow | 287 | $397.5K | $1.4K | 7.09x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.5K | $379.0K | $250.30 | 5.38x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 121 | $369.7K | $3.1K | 3.19x |
| V2785 | Processing, preserving and transporting corneal tissue | 105 | $333.6K | $3.2K | 1.56x |
| 66710 | Destruction of lens tissue using laser | 327 | $270.2K | $826.20 | 4.48x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 55 | $202.7K | $3.7K | 6.39x |
| 66170 | Creation of eye fluid drainage tract | 194 | $170.0K | $876.47 | 6.27x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 178 | $116.8K | $656.44 | 7.98x |
| 66183 | Insertion of eye fluid drainage device | 59 | $106.5K | $1.8K | 5.39x |
| 65756 | Transplant of outer layer of corneal tissue | 49 | $95.3K | $1.9K | 4.99x |
| 67903 | Shortening or advancement of upper eyelid muscle to correct drooping or paralysis | 147 | $91.6K | $622.90 | 7.18x |
| 66250 | Revision or repair of operative wound of eye | 103 | $86.9K | $843.30 | 4.40x |
| 66179 | Creation of shunt to improve eye fluid flow | 39 | $80.0K | $2.1K | 4.75x |
| 66172 | Creation of eye fluid drainage tract | 76 | $73.5K | $967.74 | 5.70x |
This provider submits charges 5.26 times higher than what Medicare actually pays.
A markup ratio of 5.26x means for every $100 Medicare pays, this provider initially charges $526. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Specialty Surgical Center, Llc | Beverly Hills, CA | $49.2M | ✓ Clear |
| Santa Rosa Surgery Center L P | Santa Rosa, CA | $41.3M | ✓ Clear |
| Peninsula Eye Surgery Center Llc | Mountain View, CA | $37.0M | ✓ Clear |
| Fort Sutter Surgery Center A California Limited Partnership | Sacramento, CA | $33.6M | ✓ Clear |
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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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