This provider's $19.7M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
78% 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 | $2.6K | $731.61 | 3.55x | $1.9K | $2.0M | 3.0K | 2.2K |
| 2015 | $2.7K | $711.05 | 3.76x | $2.0K | $1.7M | 2.7K | 2.0K |
| 2016 | $1.8K | $420.69 | 4.21x | $1.4K | $2.0M | 3.2K | 2.3K |
| 2017 | $2.2K | $600.15 | 3.69x | $1.6K | $2.3M | 3.5K | 2.4K |
| 2018 | $2.3K | $543.55 | 4.19x | $1.7K | $2.0M | 3.2K | 2.2K |
| 2019 | $2.3K | $569.63 | 3.99x | $1.7K | $2.1M | 3.1K | 2.1K |
| 2020 | $2.4K | $679.48 | 3.57x | $1.7K | $1.9M | 2.6K | 1.8K |
| 2021 | $2.1K | $482.90 | 4.30x | $1.6K | $1.6M | 2.7K | 1.8K |
| 2022 | $2.5K | $627.70 | 3.93x | $1.8K | $2.1M | 3.1K | 2.0K |
| 2023 | $2.8K | $733.04 | 3.80x | $2.1K | $2.1M | 2.7K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 18.8K | $15.1M | $802.85 | 3.82x |
| 65820 | Incision to improve eye fluid flow | 822 | $1.3M | $1.5K | 3.63x |
| 66982 | Removal of cataract with insertion of lens | 865 | $694.2K | $802.50 | 3.82x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 4.0K | $686.4K | $172.41 | 5.51x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 955 | $480.4K | $503.03 | 5.65x |
| 66710 | Destruction of lens tissue using laser | 306 | $188.8K | $617.07 | 3.08x |
| 66180 | Creation of shunt to improve eye fluid flow | 92 | $132.5K | $1.4K | 3.17x |
| 65426 | Removal or relocation of corneal conjunctiva | 187 | $125.0K | $668.20 | 4.32x |
| 67042 | Removal of membrane from the retina, pars plana approach | 77 | $112.3K | $1.5K | 3.50x |
| 67904 | Repair of tendon of upper eyelid | 211 | $111.1K | $526.49 | 4.22x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 589 | $96.5K | $163.76 | 5.57x |
| 66183 | Insertion of eye fluid drainage device | 31 | $73.2K | $2.4K | 3.37x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 663 | $67.2K | $101.40 | 7.24x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 566 | $67.1K | $118.48 | 5.95x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 270 | $55.5K | $205.55 | 6.60x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 25 | $50.3K | $2.0K | 1.64x |
| 67145 | Preventive retinal detachment treatment by heat or laser, 1 or more sessions | 240 | $45.6K | $189.91 | 4.84x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 420 | $45.0K | $107.03 | 1.49x |
| 67041 | Removal of membrane from the retina | 26 | $37.3K | $1.4K | 3.56x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 25 | $36.3K | $1.5K | 2.97x |
This provider submits charges 3.93 times higher than what Medicare actually pays.
A markup ratio of 3.93x means for every $100 Medicare pays, this provider initially charges $393. 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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