This provider's $23.1M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.47x is significantly above the specialty median of 6.1x.
62% 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 | $3.4K | $704.26 | 4.76x | $2.6K | $2.0M | 3.6K | 2.6K |
| 2015 | $3.4K | $684.76 | 4.97x | $2.7K | $2.1M | 3.8K | 2.8K |
| 2016 | $3.4K | $684.35 | 5.03x | $2.8K | $2.2M | 4.0K | 3.0K |
| 2017 | $3.7K | $715.39 | 5.15x | $3.0K | $2.0M | 3.4K | 2.5K |
| 2018 | $3.8K | $753.11 | 4.99x | $3.0K | $2.4M | 3.7K | 2.8K |
| 2019 | $3.8K | $809.15 | 4.64x | $2.9K | $2.6M | 3.9K | 2.8K |
| 2020 | $4.2K | $866.83 | 4.82x | $3.3K | $2.2M | 2.9K | 2.1K |
| 2021 | $4.4K | $1.0K | 4.24x | $3.4K | $2.6M | 3.4K | 2.4K |
| 2022 | $4.4K | $897.60 | 4.87x | $3.5K | $2.5M | 3.2K | 2.3K |
| 2023 | $4.4K | $863.71 | 5.13x | $3.6K | $2.6M | 3.4K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 15.8K | $11.9M | $753.07 | 5.81x |
| 67042 | Removal of membrane from the retina, pars plana approach | 624 | $855.9K | $1.4K | 3.45x |
| 52000 | Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope | 3.5K | $772.1K | $217.87 | 5.74x |
| 66982 | Removal of cataract with insertion of lens | 862 | $624.6K | $724.62 | 5.36x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 424 | $557.4K | $1.3K | 3.71x |
| 0191T | Internal insertion of eye fluid drainage device | 235 | $478.9K | $2.0K | 2.09x |
| 62311 | Injections of substances into lower or sacral spine | 1.5K | $407.8K | $269.73 | 6.07x |
| 50590 | Shock wave crushing of kidney stones | 345 | $405.5K | $1.2K | 4.03x |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 72 | $380.7K | $5.3K | 1.33x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 209 | $355.4K | $1.7K | 2.47x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 142 | $349.4K | $2.5K | 2.04x |
| 49505 | Repair of groin hernia patient age 5 years or older | 289 | $300.8K | $1.0K | 4.43x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 202 | $281.4K | $1.4K | 6.03x |
| 64721 | Release and/or relocation of median nerve of hand | 447 | $256.4K | $573.71 | 8.26x |
| V2785 | Processing, preserving and transporting corneal tissue | 74 | $250.7K | $3.4K | 1.37x |
| 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 1.0K | $237.8K | $235.18 | 7.57x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 1.1K | $235.4K | $223.10 | 7.94x |
| 52224 | Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope | 284 | $223.3K | $786.19 | 2.85x |
| 29881 | Removal of one knee cartilage using an endoscope | 222 | $211.3K | $951.59 | 4.93x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 390 | $207.3K | $531.55 | 4.73x |
This provider submits charges 5.47 times higher than what Medicare actually pays.
A markup ratio of 5.47x means for every $100 Medicare pays, this provider initially charges $547. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Main Line Surgery Center, Llc | Bala Cynwyd, PA | $38.7M | ✓ 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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