This provider's $10.2M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.94x 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 | $6.0K | $738.45 | 8.07x | $5.2K | $943.0K | 1.4K | 1.1K |
| 2015 | $6.6K | $832.72 | 7.87x | $5.7K | $952.8K | 1.3K | 1.1K |
| 2016 | $5.7K | $651.08 | 8.75x | $5.0K | $988.5K | 1.3K | 1.1K |
| 2017 | $5.9K | $648.38 | 9.04x | $5.2K | $940.7K | 1.4K | 1.1K |
| 2018 | $5.2K | $687.40 | 7.60x | $4.5K | $1.2M | 2.0K | 1.5K |
| 2019 | $5.4K | $705.22 | 7.61x | $4.7K | $1.0M | 1.8K | 1.4K |
| 2020 | $5.2K | $717.42 | 7.19x | $4.4K | $818.2K | 1.1K | 893 |
| 2021 | $5.8K | $903.04 | 6.47x | $4.9K | $966.7K | 1.1K | 936 |
| 2022 | $5.6K | $825.31 | 6.81x | $4.8K | $1.0M | 1.4K | 1.1K |
| 2023 | $8.4K | $1.6K | 5.37x | $6.8K | $1.3M | 1.3K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 5.7K | $4.1M | $722.08 | 9.67x |
| 67042 | Removal of membrane from the retina, pars plana approach | 1.1K | $1.5M | $1.3K | 6.58x |
| 66180 | Creation of shunt to improve eye fluid flow | 482 | $707.6K | $1.5K | 4.91x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 348 | $470.5K | $1.4K | 8.72x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 339 | $443.5K | $1.3K | 7.52x |
| 66183 | Insertion of eye fluid drainage device, external approach | 175 | $366.6K | $2.1K | 3.51x |
| 66982 | Removal of cataract with insertion of lens | 496 | $354.2K | $714.05 | 10.72x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 1.2K | $296.7K | $252.52 | 6.47x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 215 | $279.7K | $1.3K | 6.97x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 399 | $228.6K | $572.93 | 4.53x |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 22 | $155.7K | $7.1K | 3.55x |
| 27447 | Replacement of knee joint, both sides of knee | 17 | $118.0K | $6.9K | 3.85x |
| 62311 | Injections of substances into lower or sacral spine | 445 | $117.1K | $263.11 | 6.19x |
| 67041 | Removal of membrane from the retina | 80 | $95.4K | $1.2K | 7.32x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 443 | $93.5K | $211.08 | 7.76x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 348 | $80.3K | $230.74 | 10.74x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 35 | $72.4K | $2.1K | 3.59x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 576 | $59.1K | $102.65 | 1.28x |
| 62321 | Injection of substance into spinal canal of upper or middle back using imaging guidance | 274 | $58.9K | $214.88 | 7.61x |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance | 95 | $55.1K | $580.43 | 4.45x |
This provider submits charges 7.94 times higher than what Medicare actually pays.
A markup ratio of 7.94x means for every $100 Medicare pays, this provider initially charges $794. 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.
Other Ambulatory Surgical Center providers in VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Roanoke Valley Center For Sight Llc | Salem, VA | $57.7M | ✓ Clear |
| Stony Point Surgery Center, L.L.C | Richmond, VA | $45.5M | ✓ Clear |
| Virginia Eye Institute Inc | Richmond, VA | $40.0M | ✓ Clear |
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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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