This provider's $32.7M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 16.13x 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 | $9.4K | $741.96 | 12.68x | $8.7K | $2.9M | 3.9K | 34 |
| 2015 | $10.0K | $750.25 | 13.34x | $9.3K | $2.8M | 3.7K | 34 |
| 2016 | $10.5K | $703.28 | 14.97x | $9.8K | $2.7M | 3.8K | 29 |
| 2017 | $11.5K | $745.44 | 15.42x | $10.8K | $3.2M | 4.2K | 35 |
| 2018 | $12.1K | $748.28 | 16.22x | $11.4K | $3.2M | 4.2K | 33 |
| 2019 | $13.1K | $770.74 | 17.00x | $12.3K | $3.5M | 4.5K | 34 |
| 2020 | $13.6K | $794.80 | 17.12x | $12.8K | $3.1M | 3.9K | 32 |
| 2021 | $11.9K | $661.88 | 18.00x | $11.3K | $3.7M | 5.6K | 36 |
| 2022 | $11.2K | $629.83 | 17.83x | $10.6K | $3.7M | 5.9K | 32 |
| 2023 | $10.1K | $592.44 | 17.01x | $9.5K | $4.0M | 6.8K | 34 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 13.0K | $10.0M | $765.61 | 17.14x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 1.7K | $2.5M | $1.4K | 14.31x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 4.9K | $1.9M | $387.62 | 16.36x |
| V2785 | Processing, preserving and transporting corneal tissue | 638 | $1.6M | $2.5K | 9.19x |
| 66170 | Creation of eye fluid drainage tract for treatment of glaucoma | 1.8K | $1.3M | $744.91 | 21.05x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 894 | $1.3M | $1.4K | 15.63x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 1.6K | $1.2M | $764.79 | 18.02x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 736 | $1.2M | $1.7K | 14.31x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 770 | $1.1M | $1.4K | 17.78x |
| 0191T | Internal insertion of eye fluid drainage device | 453 | $965.8K | $2.1K | 15.97x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 671 | $929.7K | $1.4K | 12.32x |
| 65756 | Transplantation of outer layer of corneal tissue | 536 | $748.7K | $1.4K | 8.53x |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 2.3K | $565.9K | $248.52 | 25.53x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 215 | $545.4K | $2.5K | 16.16x |
| 45380 | Biopsy of large bowel using a flexible endoscope | 1.9K | $534.3K | $274.83 | 22.52x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 5.1K | $519.6K | $102.77 | 13.85x |
| 67039 | Destruction of eye fluid (vitreous) between lens and retina using a laser | 309 | $442.6K | $1.4K | 12.40x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 293 | $416.8K | $1.4K | 11.81x |
| 66174 | Dilation of fluid outflow drainage within eye | 351 | $393.9K | $1.1K | 19.44x |
| 67041 | Removal of membrane of retina | 286 | $379.4K | $1.3K | 12.03x |
This provider submits charges 16.13 times higher than what Medicare actually pays.
A markup ratio of 16.13x means for every $100 Medicare pays, this provider initially charges $1613. 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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