This provider's $4.5M in total Medicare payments ranks in the 93th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.11x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 1350% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 231% in 2022
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 | $4.7K | $864.64 | 5.41x | $3.8K | $96.7K | 107 | 94 |
| 2015 | $4.7K | $808.55 | 5.82x | $3.9K | $44.6K | 50 | 46 |
| 2016 | $6.7K | $951.41 | 7.01x | $5.7K | $108.5K | 109 | 100 |
| 2017 | $7.2K | $1.1K | 6.51x | $6.1K | $154.9K | 126 | 121 |
| 2018 | $8.7K | $1.3K | 6.71x | $7.4K | $212.0K | 164 | 153 |
| 2019 | $7.1K | $978.58 | 7.29x | $6.2K | $297.3K | 279 | 257 |
| 2020 | $8.0K | $1.2K | 6.89x | $6.8K | $418.2K | 312 | 300 |
| 2021 | $7.0K | $977.73 | 7.12x | $6.0K | $407.7K | 351 | 327 |
| 2022 | $7.4K | $1.1K | 6.59x | $6.2K | $1.3M | 1.1K | 947 |
| 2023 | $8.8K | $1.1K | 7.66x | $7.6K | $1.4M | 1.1K | 966 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67042 | Removal of membrane from the retina, pars plana approach | 825 | $1.3M | $1.5K | 5.61x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 478 | $736.9K | $1.5K | 9.45x |
| 66984 | Removal of cataract with insertion of lens | 739 | $595.5K | $805.79 | 8.25x |
| 67041 | Removal of membrane from the retina | 320 | $464.0K | $1.5K | 5.52x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 249 | $382.5K | $1.5K | 6.31x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 220 | $343.8K | $1.6K | 8.07x |
| 67039 | Destruction of eye fluid (vitreous) between lens and retina using a laser | 70 | $111.3K | $1.6K | 9.59x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 66 | $100.4K | $1.5K | 9.83x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 44 | $93.9K | $2.1K | 3.50x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 118 | $58.0K | $491.44 | 6.96x |
| 67121 | Removal of implant material from inside of eye | 57 | $45.8K | $804.38 | 11.07x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 72 | $41.8K | $580.15 | 5.13x |
| 67908 | Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis | 74 | $40.0K | $540.98 | 5.70x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 14 | $37.5K | $2.7K | 4.65x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 40 | $34.9K | $871.25 | 6.93x |
| 66986 | Exchange of prosthetic lens | 56 | $25.8K | $460.15 | 9.58x |
| 66852 | Removal of lens material | 12 | $19.2K | $1.6K | 2.46x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 71 | $18.4K | $259.50 | 12.61x |
| 67900 | Repair of brow paralysis | 39 | $16.5K | $424.24 | 11.53x |
| 62311 | Injections of substances into lower or sacral spine | 55 | $15.9K | $289.01 | 7.38x |
This provider submits charges 7.11 times higher than what Medicare actually pays.
A markup ratio of 7.11x means for every $100 Medicare pays, this provider initially charges $711. 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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