This provider's $14.5M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.06x is significantly above the specialty median of 6.1x.
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 | $4.2K | $836.00 | 5.08x | $3.4K | $1.3M | 1.9K | 1.6K |
| 2015 | $4.2K | $846.70 | 4.96x | $3.3K | $1.4M | 2.1K | 1.7K |
| 2016 | $4.9K | $916.12 | 5.33x | $4.0K | $1.3M | 2.0K | 1.6K |
| 2017 | $4.8K | $981.80 | 4.92x | $3.8K | $1.3M | 1.9K | 1.6K |
| 2018 | $4.5K | $979.44 | 4.58x | $3.5K | $1.5M | 2.1K | 1.7K |
| 2019 | $4.7K | $1.0K | 4.68x | $3.7K | $1.6M | 2.2K | 1.8K |
| 2020 | $4.9K | $971.73 | 5.07x | $4.0K | $1.3M | 1.8K | 1.5K |
| 2021 | $5.0K | $1.2K | 4.25x | $3.8K | $1.7M | 2.3K | 1.8K |
| 2022 | $5.1K | $1.2K | 4.38x | $4.0K | $1.5M | 2.0K | 1.6K |
| 2023 | $5.1K | $1.2K | 4.38x | $3.9K | $1.7M | 2.3K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 10.6K | $7.3M | $686.78 | 4.88x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina | 575 | $736.9K | $1.3K | 5.19x |
| 67042 | Removal of membrane from the retina, pars plana approach | 554 | $705.5K | $1.3K | 5.12x |
| V2785 | Processing, preserving and transporting corneal tissue | 226 | $678.1K | $3.0K | 1.40x |
| 65820 | Incision to improve eye fluid flow | 482 | $628.1K | $1.3K | 5.10x |
| 66982 | Removal of cataract with insertion of lens | 883 | $624.5K | $707.24 | 4.74x |
| 67041 | Removal of membrane from the retina | 489 | $606.7K | $1.2K | 5.34x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 3.5K | $529.6K | $150.03 | 10.34x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 955 | $405.5K | $424.62 | 5.05x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 304 | $385.2K | $1.3K | 5.16x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 287 | $360.2K | $1.3K | 5.28x |
| 65756 | Transplant of outer layer of corneal tissue | 187 | $240.7K | $1.3K | 4.89x |
| 66180 | Creation of shunt to improve eye fluid flow | 159 | $238.1K | $1.5K | 4.40x |
| 66183 | Insertion of eye fluid drainage device | 129 | $203.6K | $1.6K | 4.33x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 159 | $203.0K | $1.3K | 5.18x |
| 67904 | Repair of tendon of upper eyelid | 223 | $98.6K | $441.99 | 5.97x |
| 0191T | Internal insertion of eye fluid drainage device | 57 | $94.6K | $1.7K | 2.52x |
| 68720 | Creation of drainage tract from tear sac to the nasal cavity | 90 | $83.6K | $928.44 | 2.75x |
| 65850 | Insertion of eye fluid drainage tube | 191 | $78.6K | $411.77 | 14.82x |
| 66174 | Dilation of fluid outflow drainage within eye | 52 | $72.6K | $1.4K | 4.65x |
This provider submits charges 5.06 times higher than what Medicare actually pays.
A markup ratio of 5.06x means for every $100 Medicare pays, this provider initially charges $506. 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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