This provider's $45.5M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
63% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of prosthetic 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 | $2.2K | $670.71 | 3.24x | $1.5K | $4.3M | 6.4K | 33 |
| 2015 | $2.2K | $655.61 | 3.40x | $1.6K | $4.1M | 6.3K | 34 |
| 2016 | $2.4K | $717.10 | 3.29x | $1.6K | $4.5M | 6.3K | 34 |
| 2017 | $2.3K | $719.85 | 3.21x | $1.6K | $4.7M | 6.5K | 35 |
| 2018 | $2.4K | $724.28 | 3.28x | $1.7K | $4.6M | 6.3K | 34 |
| 2019 | $2.3K | $711.06 | 3.19x | $1.6K | $4.7M | 6.6K | 29 |
| 2020 | $1.9K | $597.02 | 3.20x | $1.3K | $3.9M | 6.6K | 28 |
| 2021 | $1.7K | $578.30 | 2.99x | $1.2K | $4.7M | 8.2K | 28 |
| 2022 | $1.8K | $618.10 | 2.96x | $1.2K | $5.0M | 8.0K | 30 |
| 2023 | $1.9K | $641.75 | 3.00x | $1.3K | $4.9M | 7.6K | 28 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 34.1K | $25.6M | $750.61 | 3.35x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 4.5K | $3.2M | $728.87 | 3.45x |
| V2785 | Processing, preserving and transporting corneal tissue | 920 | $2.7M | $2.9K | 1.30x |
| 0191T | Internal insertion of eye fluid drainage device | 746 | $1.4M | $1.8K | 2.05x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 981 | $1.3M | $1.4K | 2.53x |
| 65756 | Transplantation of outer layer of corneal tissue | 770 | $1.0M | $1.4K | 3.62x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 9.1K | $721.1K | $79.47 | 2.78x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 500 | $682.5K | $1.4K | 2.23x |
| 65820 | Incision to improve eye fluid flow | 391 | $513.3K | $1.3K | 2.30x |
| 67904 | Repair of tendon of upper eyelid | 871 | $396.2K | $454.85 | 4.00x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 281 | $362.8K | $1.3K | 2.15x |
| 0449T | Insertion of initial aqueous fluid drainage device into eye | 158 | $354.0K | $2.2K | 1.64x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 1.8K | $331.1K | $185.91 | 6.81x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 877 | $323.0K | $368.29 | 1.87x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 238 | $317.7K | $1.3K | 2.64x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 1.3K | $310.1K | $236.70 | 5.24x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 695 | $284.8K | $409.80 | 5.86x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 173 | $283.9K | $1.6K | 1.83x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 745 | $278.4K | $373.71 | 3.60x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 109 | $270.9K | $2.5K | 1.58x |
This provider submits charges 3.17 times higher than what Medicare actually pays.
A markup ratio of 3.17x means for every $100 Medicare pays, this provider initially charges $317. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Roanoke Valley Center For Sight Llc | Salem, VA | $57.7M | ✓ Clear |
| Virginia Eye Institute Inc | Richmond, VA | $40.0M | ✓ 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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