This provider's $23.2M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
67% 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 | $2.1K | $514.20 | 4.16x | $1.6K | $2.1M | 3.8K | 2.7K |
| 2015 | $2.0K | $469.26 | 4.20x | $1.5K | $1.9M | 3.6K | 2.6K |
| 2016 | $2.0K | $507.71 | 3.89x | $1.5K | $2.0M | 3.6K | 2.5K |
| 2017 | $1.8K | $513.87 | 3.55x | $1.3K | $2.9M | 5.6K | 3.8K |
| 2018 | $1.9K | $518.53 | 3.65x | $1.4K | $2.5M | 4.4K | 3.0K |
| 2019 | $1.9K | $539.57 | 3.56x | $1.4K | $2.9M | 6.1K | 4.0K |
| 2020 | $1.9K | $586.57 | 3.21x | $1.3K | $2.0M | 4.2K | 2.7K |
| 2021 | $1.9K | $581.21 | 3.28x | $1.3K | $2.4M | 5.7K | 3.6K |
| 2022 | $1.8K | $505.39 | 3.54x | $1.3K | $2.2M | 5.2K | 3.3K |
| 2023 | $1.6K | $457.06 | 3.55x | $1.2K | $2.2M | 5.4K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 20.7K | $15.5M | $749.03 | 3.94x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 4.2K | $1.6M | $367.68 | 1.70x |
| 66982 | Removal of cataract with insertion of lens | 2.1K | $1.5M | $744.18 | 4.04x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 8.0K | $1.5M | $183.40 | 4.77x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 8.0K | $634.7K | $79.80 | 1.97x |
| 0191T | Internal insertion of eye fluid drainage device | 228 | $447.4K | $2.0K | 1.69x |
| 67904 | Repair of tendon of upper eyelid | 800 | $381.7K | $477.11 | 4.20x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 554 | $237.6K | $428.79 | 5.27x |
| 67042 | Removal of membrane from the retina, pars plana approach | 160 | $210.5K | $1.3K | 3.64x |
| 65820 | Incision to improve eye fluid flow | 134 | $192.2K | $1.4K | 1.74x |
| 68326 | Reconstruction of conjunctiva | 199 | $189.0K | $949.78 | 2.29x |
| 67917 | Extensive repair of turning-outward eyelid defect | 380 | $157.1K | $413.30 | 4.85x |
| 67961 | Removal of up to one-fourth of the eyelid involving lid margin | 287 | $127.2K | $443.33 | 3.90x |
| 67924 | Repair of turning-inward eyelid defect | 164 | $65.6K | $400.17 | 5.02x |
| 67882 | Creation of permanent eyelid margin scarring with relocation of eyelid tissue | 177 | $55.8K | $315.33 | 5.48x |
| 66174 | Dilation to improve eye fluid flow | 36 | $51.6K | $1.4K | 2.44x |
| 67966 | Removal of over one-fourth of the eyelid involving lid margin | 98 | $43.6K | $444.81 | 3.89x |
| 68720 | Creation of drainage tract from tear sac to the nasal cavity | 42 | $39.3K | $935.75 | 2.32x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 87 | $31.4K | $360.63 | 6.10x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 238 | $31.3K | $131.43 | 7.65x |
This provider submits charges 3.76 times higher than what Medicare actually pays.
A markup ratio of 3.76x means for every $100 Medicare pays, this provider initially charges $376. 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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