This provider's $19.6M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
74% 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 | $1.6K | $793.91 | 2.04x | $826.92 | $1.6M | 2.6K | 1.7K |
| 2015 | $1.6K | $770.05 | 2.06x | $813.28 | $1.7M | 2.7K | 1.7K |
| 2016 | $1.5K | $549.29 | 2.67x | $917.38 | $1.7M | 2.8K | 1.7K |
| 2017 | $1.8K | $859.70 | 2.09x | $941.13 | $2.0M | 3.1K | 2.0K |
| 2018 | $2.1K | $963.96 | 2.20x | $1.2K | $2.0M | 3.1K | 1.9K |
| 2019 | $2.0K | $1.0K | 1.97x | $976.93 | $2.3M | 3.3K | 2.0K |
| 2020 | $2.4K | $1.2K | 1.97x | $1.2K | $1.8M | 2.4K | 1.5K |
| 2021 | $2.6K | $1.3K | 1.99x | $1.3K | $2.1M | 2.5K | 1.6K |
| 2022 | $2.6K | $1.3K | 2.04x | $1.3K | $2.3M | 2.7K | 1.7K |
| 2023 | $2.5K | $1.2K | 2.09x | $1.3K | $2.2M | 2.5K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 20.1K | $14.5M | $719.65 | 2.78x |
| 0191T | Internal insertion of eye fluid drainage device | 649 | $1.1M | $1.7K | 1.48x |
| V2785 | Processing, preserving and transporting corneal tissue | 300 | $816.0K | $2.7K | 1.29x |
| 66982 | Removal of cataract with insertion of lens | 609 | $436.2K | $716.18 | 2.79x |
| 65756 | Transplant of outer layer of corneal tissue | 312 | $413.5K | $1.3K | 2.00x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.1K | $371.2K | $176.62 | 5.10x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 263 | $365.4K | $1.4K | 2.16x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 193 | $267.0K | $1.4K | 2.25x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 116 | $253.5K | $2.2K | 1.69x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.8K | $190.8K | $108.07 | 8.33x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 71 | $143.7K | $2.0K | 1.48x |
| 67042 | Removal of membrane from the retina, pars plana approach | 95 | $132.4K | $1.4K | 2.18x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 84 | $131.2K | $1.6K | 1.81x |
| 67041 | Removal of membrane from the retina | 77 | $107.5K | $1.4K | 2.24x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina, complex | 53 | $73.8K | $1.4K | 2.16x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 172 | $62.8K | $364.87 | 4.07x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 41 | $55.3K | $1.3K | 2.22x |
| 66710 | Destruction of lens tissue using laser | 91 | $53.2K | $585.04 | 2.42x |
| 66179 | Creation of shunt to improve eye fluid flow | 27 | $43.0K | $1.6K | 1.57x |
| 66986 | Exchange of lens prosthesis | 51 | $29.9K | $586.35 | 3.08x |
This provider submits charges 2.67 times higher than what Medicare actually pays.
A markup ratio of 2.67x means for every $100 Medicare pays, this provider initially charges $267. 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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