This provider's $19.3M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.91x 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 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 | $4.1K | $881.88 | 4.63x | $3.2K | $1.7M | 2.2K | 1.6K |
| 2015 | $4.6K | $1.1K | 4.23x | $3.5K | $1.7M | 2.3K | 1.6K |
| 2016 | $4.7K | $957.88 | 4.88x | $3.7K | $1.9M | 2.5K | 1.8K |
| 2017 | $4.7K | $1.1K | 4.20x | $3.6K | $2.0M | 2.4K | 1.7K |
| 2018 | $5.8K | $1.1K | 5.55x | $4.8K | $2.3M | 2.8K | 2.0K |
| 2019 | $6.8K | $1.1K | 6.44x | $5.8K | $2.2M | 2.7K | 1.9K |
| 2020 | $6.8K | $1.1K | 6.07x | $5.7K | $1.7M | 1.9K | 1.3K |
| 2021 | $6.7K | $1.1K | 5.89x | $5.5K | $1.8M | 2.1K | 1.4K |
| 2022 | $7.5K | $1.2K | 6.21x | $6.3K | $2.0M | 2.6K | 1.8K |
| 2023 | $7.6K | $1.2K | 6.37x | $6.4K | $1.9M | 2.7K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 16.0K | $11.5M | $714.41 | 9.52x |
| V2785 | Processing, preserving and transporting corneal tissue | 480 | $1.3M | $2.6K | 1.32x |
| 0191T | Internal insertion of eye fluid drainage device | 601 | $1.0M | $1.7K | 4.33x |
| 66982 | Removal of cataract with insertion of lens | 1.4K | $981.1K | $705.32 | 9.35x |
| 67042 | Removal of membrane from the retina, pars plana approach | 682 | $895.1K | $1.3K | 5.90x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 550 | $718.4K | $1.3K | 6.50x |
| 67041 | Removal of membrane from the retina | 436 | $555.1K | $1.3K | 6.04x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 280 | $368.6K | $1.3K | 6.26x |
| 65755 | Transplantation of tissue from one cornea to other cornea | 282 | $368.5K | $1.3K | 5.50x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 250 | $336.0K | $1.3K | 6.50x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 128 | $174.1K | $1.4K | 6.90x |
| 65756 | Transplant of outer layer of corneal tissue | 127 | $162.0K | $1.3K | 5.44x |
| 65820 | Incision to improve eye fluid flow | 112 | $158.1K | $1.4K | 4.51x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 817 | $142.0K | $173.85 | 12.63x |
| 66710 | Destruction of lens tissue using laser | 203 | $120.6K | $594.22 | 5.28x |
| 67039 | Laser destruction of eye fluid (vitreous) between the lens and retina | 68 | $92.0K | $1.4K | 6.05x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1.1K | $88.1K | $78.10 | 1.73x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 34 | $60.9K | $1.8K | 6.84x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 25 | $60.0K | $2.4K | 5.06x |
| 66250 | Revision or repair of operative wound of eye | 87 | $49.1K | $564.83 | 5.21x |
This provider submits charges 7.91 times higher than what Medicare actually pays.
A markup ratio of 7.91x means for every $100 Medicare pays, this provider initially charges $791. 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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