This provider's $28.5M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
75% 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.
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 | $2.2K | $671.75 | 3.29x | $1.5K | $2.7M | 4.1K | 13 |
| 2015 | $2.2K | $672.97 | 3.31x | $1.6K | $2.8M | 4.2K | 13 |
| 2016 | $2.3K | $694.05 | 3.25x | $1.6K | $3.0M | 4.3K | 17 |
| 2017 | $2.2K | $683.19 | 3.26x | $1.5K | $2.7M | 4.0K | 15 |
| 2018 | $2.3K | $725.82 | 3.14x | $1.6K | $3.0M | 4.1K | 17 |
| 2019 | $2.3K | $709.66 | 3.29x | $1.6K | $2.8M | 4.0K | 15 |
| 2020 | $2.3K | $739.90 | 3.14x | $1.6K | $2.1M | 2.9K | 14 |
| 2021 | $2.4K | $777.40 | 3.05x | $1.6K | $2.9M | 3.7K | 13 |
| 2022 | $2.7K | $805.24 | 3.31x | $1.9K | $3.3M | 4.1K | 15 |
| 2023 | $2.6K | $801.74 | 3.29x | $1.8K | $3.2M | 3.9K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 26.6K | $21.1M | $793.37 | 3.15x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 2.1K | $1.6M | $783.74 | 3.83x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 370 | $958.6K | $2.6K | 4.18x |
| 0191T | Internal insertion of eye fluid drainage device | 353 | $744.8K | $2.1K | 1.53x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 3.2K | $622.8K | $194.79 | 4.88x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 746 | $363.3K | $487.00 | 3.09x |
| V2785 | Processing, preserving and transporting corneal tissue | 103 | $300.5K | $2.9K | 1.28x |
| 65855 | Laser repair to improve eye fluid flow | 2.3K | $273.9K | $119.08 | 7.98x |
| 66174 | Dilation of fluid outflow drainage within eye | 273 | $269.6K | $987.58 | 4.61x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 168 | $263.6K | $1.6K | 1.93x |
| 0449T | Insertion of initial aqueous fluid drainage device into eye | 115 | $261.7K | $2.3K | 3.49x |
| 66183 | Insertion of eye fluid drainage device | 158 | $219.4K | $1.4K | 2.15x |
| 67908 | Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis | 378 | $200.9K | $531.49 | 2.83x |
| 67917 | Extensive repair of turning-outward eyelid defect | 320 | $186.2K | $581.93 | 2.58x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 112 | $159.9K | $1.4K | 3.21x |
| 67904 | Repair of tendon of upper eyelid | 247 | $125.3K | $507.15 | 2.96x |
| 65756 | Transplant of outer layer of corneal tissue | 78 | $111.2K | $1.4K | 1.91x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 41 | $106.0K | $2.6K | 4.28x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 51 | $98.3K | $1.9K | 1.29x |
| 67924 | Extensive repair of turning-inward eyelid defect | 140 | $86.0K | $613.99 | 2.43x |
This provider submits charges 3.24 times higher than what Medicare actually pays.
A markup ratio of 3.24x means for every $100 Medicare pays, this provider initially charges $324. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| West Suburban Eye Surgery Center Llc | Waltham, MA | $37.4M | ✓ 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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