This provider's $20.7M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
75% 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 | $1.8K | $522.19 | 3.41x | $1.3K | $1.8M | 2.9K | 1.9K |
| 2015 | $2.1K | $666.59 | 3.21x | $1.5K | $1.9M | 3.0K | 2.0K |
| 2016 | $2.1K | $652.88 | 3.27x | $1.5K | $1.9M | 3.5K | 2.2K |
| 2017 | $2.4K | $761.75 | 3.15x | $1.6K | $2.0M | 3.4K | 2.2K |
| 2018 | $2.3K | $745.35 | 3.05x | $1.5K | $2.1M | 3.6K | 2.2K |
| 2019 | $2.2K | $753.02 | 2.91x | $1.4K | $2.3M | 3.8K | 2.3K |
| 2020 | $2.3K | $859.14 | 2.73x | $1.5K | $1.7M | 3.4K | 2.1K |
| 2021 | $2.2K | $881.48 | 2.49x | $1.3K | $2.4M | 5.0K | 3.0K |
| 2022 | $2.4K | $976.52 | 2.42x | $1.4K | $2.3M | 4.9K | 2.9K |
| 2023 | $2.5K | $1.1K | 2.33x | $1.5K | $2.3M | 4.8K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 20.6K | $15.5M | $752.74 | 3.33x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 5.6K | $1.1M | $189.33 | 3.29x |
| 66982 | Removal of cataract with insertion of lens | 1.3K | $973.5K | $736.37 | 3.40x |
| 0191T | Internal insertion of eye fluid drainage device | 487 | $918.8K | $1.9K | 2.23x |
| 66180 | Creation of shunt to improve eye fluid flow | 374 | $571.1K | $1.5K | 2.77x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 6.3K | $494.3K | $79.00 | 2.14x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 2.5K | $271.8K | $107.58 | 3.82x |
| 65820 | Incision to improve eye fluid flow | 182 | $248.4K | $1.4K | 2.78x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 80 | $197.0K | $2.5K | 1.98x |
| 66710 | Destruction of lens tissue using laser | 249 | $150.0K | $602.56 | 3.49x |
| 66174 | Dilation to improve eye fluid flow | 48 | $66.1K | $1.4K | 2.18x |
| 66183 | Insertion of eye fluid drainage device | 27 | $59.9K | $2.2K | 1.96x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 354 | $49.7K | $140.35 | 3.85x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 23 | $33.1K | $1.4K | 2.53x |
| 67255 | Repair of defect of sclera with graft | 61 | $23.4K | $383.60 | 4.45x |
| 66170 | Creation of eye fluid drainage tract | 28 | $16.0K | $570.91 | 4.37x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 30 | $11.3K | $378.25 | 3.30x |
This provider submits charges 3.22 times higher than what Medicare actually pays.
A markup ratio of 3.22x means for every $100 Medicare pays, this provider initially charges $322. 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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