This provider's $12.5M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.82x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 52% from 2014 to 2023.
66% 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 | $1.8K | $562.32 | 3.11x | $1.2K | $998.7K | 1.6K | 1.2K |
| 2015 | $3.1K | $566.91 | 5.41x | $2.5K | $968.1K | 1.6K | 1.1K |
| 2016 | $3.2K | $565.70 | 5.73x | $2.7K | $1.0M | 1.7K | 1.2K |
| 2017 | $3.3K | $602.06 | 5.43x | $2.7K | $1.0M | 1.6K | 1.2K |
| 2018 | $3.8K | $695.69 | 5.42x | $3.1K | $1.3M | 2.0K | 1.5K |
| 2019 | $3.4K | $633.87 | 5.30x | $2.7K | $1.7M | 3.1K | 2.2K |
| 2020 | $3.9K | $694.32 | 5.67x | $3.2K | $1.2M | 2.3K | 1.6K |
| 2021 | $3.6K | $665.57 | 5.46x | $3.0K | $1.4M | 2.4K | 1.7K |
| 2022 | $5.4K | $944.89 | 5.71x | $4.5K | $1.4M | 1.9K | 1.3K |
| 2023 | $5.6K | $782.89 | 7.11x | $4.8K | $1.5M | 2.1K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 10.9K | $8.2M | $752.38 | 5.90x |
| 66982 | Removal of cataract with insertion of lens | 1.2K | $925.6K | $761.19 | 5.92x |
| 0191T | Internal insertion of eye fluid drainage device | 460 | $919.4K | $2.0K | 2.16x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.9K | $562.3K | $191.01 | 10.83x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 1.2K | $439.2K | $362.12 | 2.57x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 115 | $287.1K | $2.5K | 6.46x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 112 | $177.8K | $1.6K | 7.50x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 360 | $170.3K | $473.01 | 7.58x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1.5K | $124.7K | $83.54 | 7.25x |
| 66170 | Creation of eye fluid drainage tract | 190 | $118.7K | $624.98 | 6.73x |
| 65820 | Incision to improve eye fluid flow | 94 | $116.4K | $1.2K | 7.54x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 240 | $91.2K | $379.91 | 7.40x |
| 66183 | Insertion of eye fluid drainage device | 50 | $89.2K | $1.8K | 1.93x |
| 66174 | Dilation to improve eye fluid flow | 46 | $62.8K | $1.4K | 6.47x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 440 | $60.9K | $138.30 | 5.72x |
| 67904 | Repair of tendon of upper eyelid | 113 | $57.6K | $509.47 | 6.05x |
| 67903 | Shortening or advancement of upper eyelid muscle to correct drooping or paralysis | 60 | $31.5K | $525.66 | 6.91x |
| 67924 | Repair of turning-inward eyelid defect | 43 | $25.7K | $597.73 | 5.94x |
| 67917 | Extensive repair of turning-outward eyelid defect | 39 | $21.6K | $553.12 | 6.54x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 23 | $14.2K | $618.07 | 4.69x |
This provider submits charges 5.82 times higher than what Medicare actually pays.
A markup ratio of 5.82x means for every $100 Medicare pays, this provider initially charges $582. 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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