This provider's $29.3M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.37x is significantly above the specialty median of 6.1x.
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 | $3.5K | $637.19 | 5.50x | $2.9K | $2.8M | 6.4K | 5.7K |
| 2015 | $3.5K | $647.06 | 5.35x | $2.8K | $3.0M | 6.8K | 6.0K |
| 2016 | $3.5K | $676.68 | 5.22x | $2.9K | $3.1M | 7.1K | 6.4K |
| 2017 | $3.7K | $648.20 | 5.66x | $3.0K | $2.9M | 6.7K | 6.0K |
| 2018 | $3.7K | $699.37 | 5.28x | $3.0K | $3.2M | 6.8K | 6.0K |
| 2019 | $3.5K | $630.34 | 5.59x | $2.9K | $3.2M | 7.0K | 6.2K |
| 2020 | $4.3K | $800.76 | 5.32x | $3.5K | $2.5M | 5.2K | 4.5K |
| 2021 | $5.5K | $1.0K | 5.26x | $4.5K | $3.0M | 5.5K | 4.7K |
| 2022 | $7.0K | $1.3K | 5.36x | $5.7K | $3.0M | 5.4K | 4.7K |
| 2023 | $7.1K | $1.3K | 5.29x | $5.7K | $2.7M | 4.4K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 13.3K | $9.3M | $700.45 | 5.09x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 9.3K | $3.3M | $349.95 | 4.99x |
| 45380 | Biopsy of large bowel using an endoscope | 8.6K | $2.3M | $271.72 | 6.22x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 7.2K | $1.5M | $205.10 | 6.91x |
| 43248 | Insertion of guide wire with dilation of esophagus using an endoscope | 3.9K | $978.6K | $250.61 | 5.65x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 2.9K | $968.1K | $331.76 | 4.11x |
| 0191T | Internal insertion of eye fluid drainage device | 385 | $735.3K | $1.9K | 4.91x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 1.8K | $620.5K | $338.54 | 4.08x |
| 64721 | Release and/or relocation of median nerve of hand | 1.1K | $581.3K | $541.22 | 5.14x |
| 50590 | Shock wave crushing of kidney stones | 490 | $552.7K | $1.1K | 5.39x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 318 | $496.5K | $1.6K | 5.78x |
| 66982 | Removal of cataract with insertion of lens | 675 | $482.4K | $714.72 | 5.09x |
| 63685 | Insertion of spinal neurostimulator generator or receiver | 24 | $423.9K | $17.7K | 4.81x |
| 29848 | Release of wrist ligament using an endoscope | 745 | $401.2K | $538.46 | 5.57x |
| 65820 | Incision to improve eye fluid flow | 274 | $373.7K | $1.4K | 5.00x |
| 64590 | Insertion or replacement of peripheral or gastric neurostimulator generator | 26 | $346.8K | $13.3K | 4.94x |
| 49650 | Repair of groin hernia using an endoscope | 246 | $338.7K | $1.4K | 5.73x |
| 66180 | Creation of shunt to improve eye fluid flow | 230 | $335.9K | $1.5K | 4.91x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.3K | $328.2K | $247.48 | 5.72x |
| 67904 | Repair of tendon of upper eyelid | 569 | $264.8K | $465.44 | 6.29x |
This provider submits charges 5.37 times higher than what Medicare actually pays.
A markup ratio of 5.37x means for every $100 Medicare pays, this provider initially charges $537. 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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