This provider's $41.9M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.74x is significantly above the specialty median of 6.1x.
60% 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 | $5.2K | $596.08 | 8.69x | $4.6K | $3.6M | 6.0K | 27 |
| 2015 | $5.1K | $588.77 | 8.65x | $4.5K | $4.0M | 6.8K | 30 |
| 2016 | $5.4K | $600.07 | 8.94x | $4.8K | $4.0M | 6.7K | 28 |
| 2017 | $5.3K | $592.51 | 8.87x | $4.7K | $4.7M | 8.0K | 28 |
| 2018 | $5.8K | $647.34 | 8.90x | $5.1K | $4.9M | 7.6K | 32 |
| 2019 | $3.8K | $420.87 | 8.94x | $3.3K | $4.8M | 11.4K | 31 |
| 2020 | $2.9K | $334.43 | 8.61x | $2.5K | $3.8M | 11.4K | 24 |
| 2021 | $3.0K | $489.57 | 6.22x | $2.6K | $4.5M | 9.1K | 24 |
| 2022 | $1.7K | $385.51 | 4.44x | $1.3K | $4.1M | 10.6K | 20 |
| 2023 | $80.74 | $18.10 | 4.46x | $62.64 | $3.5M | 192.8K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 32.0K | $23.5M | $735.04 | 7.73x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 12.7K | $2.3M | $184.19 | 8.34x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 1.5K | $2.0M | $1.3K | 7.55x |
| 0191T | Internal insertion of eye fluid drainage device | 816 | $1.5M | $1.8K | 6.49x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 1.6K | $1.2M | $739.09 | 7.47x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 13.1K | $1.0M | $79.19 | 10.29x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 2.2K | $823.0K | $369.39 | 8.81x |
| V2785 | Processing, preserving and transporting corneal tissue | 268 | $818.7K | $3.1K | 1.41x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 512 | $678.8K | $1.3K | 7.52x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 478 | $641.2K | $1.3K | 7.20x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 470 | $611.1K | $1.3K | 4.70x |
| 67904 | Repair of tendon of upper eyelid | 1.2K | $548.2K | $464.19 | 10.06x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 355 | $466.3K | $1.3K | 7.35x |
| 67917 | Extensive repair of turning-outward eyelid defect | 965 | $455.6K | $472.08 | 9.70x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 1.0K | $445.6K | $436.91 | 12.08x |
| 65820 | Incision to improve eye fluid flow | 387 | $436.5K | $1.1K | 7.48x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 174 | $428.2K | $2.5K | 3.05x |
| 66174 | Dilation of fluid outflow drainage within eye | 326 | $427.2K | $1.3K | 4.28x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 4.0K | $410.9K | $103.11 | 13.34x |
| 67041 | Removal of membrane from the retina | 289 | $369.5K | $1.3K | 5.56x |
This provider submits charges 7.74 times higher than what Medicare actually pays.
A markup ratio of 7.74x means for every $100 Medicare pays, this provider initially charges $774. 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data