This provider's $5.7M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Medicare payments to this provider grew 145% from 2018 to 2023.
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.
Notable: Payments increased 90% in 2019
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 |
|---|---|---|---|---|---|---|---|
| 2018 | $3.2K | $1.1K | 2.84x | $2.0K | $476.1K | 556 | 331 |
| 2019 | $2.1K | $904.51 | 2.32x | $1.2K | $904.3K | 1.6K | 967 |
| 2020 | $2.5K | $958.48 | 2.61x | $1.5K | $864.0K | 1.8K | 1.1K |
| 2021 | $2.6K | $1.0K | 2.51x | $1.5K | $1.1M | 2.1K | 1.3K |
| 2022 | $2.3K | $846.97 | 2.70x | $1.4K | $1.2M | 2.5K | 1.6K |
| 2023 | $2.5K | $1.1K | 2.30x | $1.4K | $1.2M | 2.2K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 4.4K | $3.5M | $795.40 | 2.54x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 251 | $377.3K | $1.5K | 2.39x |
| 0191T | Internal insertion of eye fluid drainage device | 161 | $333.8K | $2.1K | 2.53x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.4K | $285.4K | $200.59 | 4.04x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3.3K | $262.0K | $79.41 | 3.15x |
| 67042 | Removal of membrane from the retina, pars plana approach | 111 | $167.2K | $1.5K | 2.44x |
| 67041 | Removal of membrane from the retina | 99 | $149.2K | $1.5K | 2.44x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 350 | $122.6K | $350.42 | 2.85x |
| 66982 | Removal of cataract with insertion of lens | 172 | $121.8K | $708.17 | 3.22x |
| V2785 | Processing, preserving and transporting corneal tissue | 42 | $104.4K | $2.5K | 1.47x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 56 | $80.3K | $1.4K | 2.57x |
| 67917 | Extensive repair of turning-outward eyelid defect | 136 | $65.8K | $483.61 | 3.34x |
| 67904 | Repair of tendon of upper eyelid | 111 | $56.5K | $509.07 | 2.95x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 13 | $26.5K | $2.0K | 1.77x |
| 66986 | Exchange of lens prosthesis | 52 | $22.3K | $429.65 | 4.70x |
| 66710 | Destruction of lens tissue using laser | 14 | $9.1K | $647.69 | 2.54x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 13 | $7.0K | $535.07 | 3.07x |
This provider submits charges 2.65 times higher than what Medicare actually pays.
A markup ratio of 2.65x means for every $100 Medicare pays, this provider initially charges $265. 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 CO for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Harmony Surgery Center, Llc | Fort Collins, CO | $37.3M | ✓ Clear |
| Surgery Center Of Northern Colorado | Fort Collins, CO | $35.8M | ✓ 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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