This provider's $37.4M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
73% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of prosthetic lens).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 50% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $3.6K | $744.11 | 4.89x | $2.9K | $3.6M | 4.8K | 16 |
| 2015 | $3.7K | $742.95 | 4.95x | $2.9K | $3.5M | 4.7K | 15 |
| 2016 | $3.8K | $754.61 | 5.00x | $3.0K | $3.7M | 4.9K | 16 |
| 2017 | $3.8K | $768.30 | 4.91x | $3.0K | $3.9M | 5.1K | 12 |
| 2018 | $4.4K | $762.16 | 5.80x | $3.7K | $3.8M | 4.9K | 13 |
| 2019 | $5.8K | $753.65 | 7.65x | $5.0K | $3.5M | 4.7K | 17 |
| 2020 | $2.7K | $586.60 | 4.56x | $2.1K | $2.6M | 4.4K | 16 |
| 2021 | $1.5K | $530.31 | 2.75x | $930.44 | $3.9M | 7.3K | 16 |
| 2022 | $1.4K | $502.52 | 2.71x | $857.09 | $4.2M | 8.3K | 17 |
| 2023 | $1.1K | $421.39 | 2.62x | $683.64 | $4.9M | 11.5K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 32.8K | $26.7M | $812.48 | 4.74x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 3.8K | $3.1M | $812.68 | 4.88x |
| 0191T | Internal insertion of eye fluid drainage device | 721 | $1.4M | $2.0K | 3.26x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 11.2K | $1.2M | $104.41 | 1.68x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 3.4K | $691.2K | $203.06 | 5.83x |
| 65820 | Incision to improve eye fluid flow | 339 | $511.8K | $1.5K | 2.54x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 173 | $460.4K | $2.7K | 2.65x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 318 | $440.8K | $1.4K | 2.67x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 260 | $366.7K | $1.4K | 3.62x |
| V2785 | Processing, preserving and transporting corneal tissue | 143 | $354.2K | $2.5K | 1.32x |
| 67041 | Removal of membrane of retina | 184 | $263.9K | $1.4K | 3.11x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3.1K | $236.7K | $76.27 | 1.97x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 431 | $214.2K | $496.93 | 7.66x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 111 | $174.4K | $1.6K | 2.16x |
| 65772 | Incision of cornea to correct astigmatism | 835 | $147.2K | $176.31 | 6.01x |
| 65756 | Transplantation of outer layer of corneal tissue | 93 | $143.3K | $1.5K | 3.06x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 78 | $115.0K | $1.5K | 3.07x |
| 66986 | Exchange of prosthetic lens | 169 | $107.6K | $636.79 | 4.93x |
| 65855 | Laser repair to improve eye fluid flow | 874 | $105.8K | $121.10 | 11.69x |
| 66761 | Creation of eye fluid drainage tracts in iris using a laser, per session | 549 | $80.6K | $146.82 | 9.13x |
This provider submits charges 4.48 times higher than what Medicare actually pays.
A markup ratio of 4.48x means for every $100 Medicare pays, this provider initially charges $448. 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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