This provider's $21.7M 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 | $2.8K | $944.09 | 2.96x | $1.8K | $1.9M | 3.2K | 1.9K |
| 2015 | $2.9K | $967.83 | 3.02x | $2.0K | $2.1M | 3.6K | 2.2K |
| 2016 | $2.7K | $917.36 | 2.97x | $1.8K | $2.1M | 3.5K | 2.1K |
| 2017 | $2.7K | $1.0K | 2.65x | $1.7K | $2.6M | 4.5K | 2.7K |
| 2018 | $3.3K | $1.1K | 2.90x | $2.2K | $2.5M | 3.9K | 2.4K |
| 2019 | $2.4K | $905.19 | 2.69x | $1.5K | $2.4M | 4.5K | 2.7K |
| 2020 | $2.9K | $1.2K | 2.53x | $1.8K | $2.0M | 3.7K | 2.2K |
| 2021 | $2.9K | $1.2K | 2.49x | $1.7K | $2.3M | 4.4K | 2.6K |
| 2022 | $3.2K | $1.3K | 2.53x | $2.0K | $2.0M | 3.9K | 2.2K |
| 2023 | $3.4K | $1.2K | 2.72x | $2.1K | $1.8M | 3.2K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 22.2K | $16.2M | $726.30 | 4.69x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 6.6K | $1.2M | $183.69 | 7.29x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 1.9K | $707.8K | $364.86 | 1.64x |
| V2785 | Processing, preserving and transporting corneal tissue | 208 | $629.0K | $3.0K | 1.28x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 421 | $556.3K | $1.3K | 2.42x |
| 66982 | Removal of cataract with insertion of lens | 632 | $455.7K | $721.10 | 4.72x |
| 67042 | Removal of membrane from the retina, pars plana approach | 270 | $357.8K | $1.3K | 2.63x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4.4K | $352.2K | $80.32 | 1.87x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 172 | $296.3K | $1.7K | 3.01x |
| 65820 | Incision to improve eye fluid flow | 211 | $288.3K | $1.4K | 2.74x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 713 | $252.7K | $354.36 | 5.03x |
| 65756 | Transplant of outer layer of corneal tissue | 133 | $178.6K | $1.3K | 3.08x |
| 66183 | Insertion of eye fluid drainage device | 50 | $98.1K | $2.0K | 2.03x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 54 | $64.2K | $1.2K | 1.49x |
| 67041 | Removal of membrane from the retina | 50 | $56.5K | $1.1K | 3.49x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 23 | $41.1K | $1.8K | 3.95x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 13 | $16.7K | $1.3K | 2.84x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 116 | $13.3K | $114.97 | 10.96x |
| J1095 | Injection, dexamethasone 9 percent, intraocular, 1 microgram | 44 | $38.85 | $0.88 | 1.38x |
This provider submits charges 4.42 times higher than what Medicare actually pays.
A markup ratio of 4.42x means for every $100 Medicare pays, this provider initially charges $442. 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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