This provider's $24.4M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.3x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 290% from 2014 to 2023.
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 | $3.5K | $506.35 | 6.88x | $3.0K | $1.2M | 2.3K | 26 |
| 2015 | $3.6K | $531.20 | 6.77x | $3.1K | $1.3M | 2.5K | 27 |
| 2016 | $3.7K | $583.37 | 6.28x | $3.1K | $1.5M | 2.6K | 31 |
| 2017 | $1.6K | $236.57 | 6.55x | $1.3K | $1.7M | 7.0K | 33 |
| 2018 | $1.5K | $235.53 | 6.42x | $1.3K | $1.9M | 8.2K | 34 |
| 2019 | $1.3K | $183.93 | 7.09x | $1.1K | $2.0M | 10.9K | 32 |
| 2020 | $871.37 | $128.40 | 6.79x | $742.97 | $2.6M | 20.3K | 35 |
| 2021 | $637.83 | $103.81 | 6.14x | $534.02 | $3.7M | 35.7K | 36 |
| 2022 | $562.74 | $98.06 | 5.74x | $464.68 | $4.0M | 40.5K | 35 |
| 2023 | $573.53 | $98.16 | 5.84x | $475.37 | $4.5M | 45.8K | 38 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 7.6K | $5.9M | $775.67 | 4.01x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 15.3K | $1.6M | $104.64 | 7.56x |
| 27447 | Replacement of knee joint, both sides of knee | 166 | $1.2M | $7.2K | 5.58x |
| 50590 | Shock wave crushing of kidney stones | 864 | $1.1M | $1.2K | 7.32x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 1.3K | $1.0M | $777.82 | 4.03x |
| 0191T | Internal insertion of eye fluid drainage device | 504 | $970.3K | $1.9K | 2.47x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 12.1K | $940.1K | $77.69 | 4.05x |
| 63685 | Insertion of spinal neurostimulator generator or receiver | 48 | $911.6K | $19.0K | 2.72x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 1.5K | $747.9K | $491.39 | 12.16x |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 3.2K | $629.8K | $195.82 | 12.60x |
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 2.2K | $616.1K | $278.51 | 8.94x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 214 | $423.5K | $2.0K | 6.04x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 150 | $387.3K | $2.6K | 3.83x |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 1.6K | $382.9K | $245.26 | 9.74x |
| 52356 | Crushing of stone of ureter with insertion of stent using an endoscope | 218 | $338.3K | $1.6K | 4.69x |
| 29881 | Removal of knee cartilage using an endoscope | 322 | $323.8K | $1.0K | 6.40x |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 1.3K | $297.0K | $224.35 | 11.25x |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 56.8K | $275.9K | $4.86 | 5.02x |
| 29880 | Removal of both knee cartilages using an endoscope | 266 | $263.7K | $991.38 | 6.50x |
| 63650 | Implantation of spinal neurostimulator electrodes, accessed through the skin | 69 | $247.5K | $3.6K | 3.76x |
This provider submits charges 6.3 times higher than what Medicare actually pays.
A markup ratio of 6.3x means for every $100 Medicare pays, this provider initially charges $630. 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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