This provider's $13.2M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 11.92x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 109% from 2014 to 2023.
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 | $8.9K | $909.38 | 9.81x | $8.0K | $1.0M | 1.2K | 930 |
| 2015 | $7.7K | $776.18 | 9.93x | $6.9K | $1.2M | 1.6K | 1.3K |
| 2016 | $7.2K | $704.23 | 10.19x | $6.5K | $1.1M | 1.6K | 1.3K |
| 2017 | $7.2K | $753.39 | 9.50x | $6.4K | $835.6K | 1.1K | 949 |
| 2018 | $8.4K | $804.37 | 10.40x | $7.6K | $947.9K | 1.2K | 958 |
| 2019 | $7.5K | $668.95 | 11.21x | $6.8K | $1.2M | 1.7K | 1.4K |
| 2020 | $7.3K | $699.15 | 10.50x | $6.6K | $1.1M | 1.5K | 1.2K |
| 2021 | $6.3K | $604.85 | 10.38x | $5.7K | $1.6M | 2.3K | 1.9K |
| 2022 | $8.1K | $762.72 | 10.65x | $7.4K | $2.0M | 2.8K | 2.4K |
| 2023 | $9.4K | $887.69 | 10.55x | $8.5K | $2.2M | 2.9K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 9.0K | $7.7M | $858.27 | 12.89x |
| 66174 | Dilation to improve eye fluid flow | 523 | $879.0K | $1.7K | 7.51x |
| 66982 | Removal of cataract with insertion of lens | 969 | $877.8K | $905.91 | 11.82x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 2.4K | $724.0K | $296.12 | 14.98x |
| 0191T | Internal insertion of eye fluid drainage device | 419 | $711.9K | $1.7K | 5.54x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 1.1K | $495.0K | $466.95 | 10.53x |
| 45380 | Biopsy of large bowel using an endoscope | 1.2K | $467.2K | $402.07 | 12.33x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.1K | $336.4K | $317.70 | 13.70x |
| 65820 | Incision to improve eye fluid flow | 196 | $233.9K | $1.2K | 11.05x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 324 | $180.1K | $555.95 | 14.58x |
| 66180 | Creation of shunt to improve eye fluid flow | 96 | $169.6K | $1.8K | 7.13x |
| 67904 | Repair of tendon of upper eyelid | 204 | $120.1K | $588.49 | 11.97x |
| 67042 | Removal of membrane from the retina, pars plana approach | 49 | $73.0K | $1.5K | 8.49x |
| 67041 | Removal of membrane from the retina | 36 | $53.6K | $1.5K | 8.51x |
| 66710 | Destruction of lens tissue using laser | 53 | $38.5K | $727.26 | 7.99x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 82 | $27.9K | $340.16 | 7.00x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 41 | $25.9K | $630.77 | 5.78x |
| 67903 | Shortening or advancement of upper eyelid muscle to correct drooping or paralysis | 36 | $15.8K | $439.10 | 13.23x |
| 66986 | Exchange of prosthetic lens | 14 | $11.7K | $838.98 | 11.46x |
| 67255 | Repair of defect of sclera with graft | 21 | $8.7K | $416.25 | 13.89x |
This provider submits charges 11.92 times higher than what Medicare actually pays.
A markup ratio of 11.92x means for every $100 Medicare pays, this provider initially charges $1192. 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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