This provider's $20.3M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 7.14x is significantly above the specialty median of 6.1x.
76% 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 186% in 2015
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $3.2K | $493.58 | 6.51x | $2.7K | $871.3K | 1.4K | 1.1K |
| 2015 | $3.0K | $468.32 | 6.36x | $2.5K | $2.5M | 4.0K | 2.8K |
| 2016 | $3.1K | $554.10 | 5.61x | $2.6K | $2.6M | 4.2K | 2.9K |
| 2017 | $3.4K | $645.21 | 5.22x | $2.7K | $2.6M | 4.1K | 2.8K |
| 2018 | $3.4K | $668.85 | 5.05x | $2.7K | $2.7M | 4.2K | 2.8K |
| 2019 | $3.1K | $633.91 | 4.87x | $2.5K | $2.7M | 4.3K | 2.9K |
| 2020 | $4.2K | $964.58 | 4.37x | $3.2K | $1.9M | 2.9K | 2.0K |
| 2021 | $4.1K | $1.2K | 3.52x | $2.9K | $2.3M | 3.4K | 2.3K |
| 2022 | $4.0K | $851.88 | 4.68x | $3.1K | $1.2M | 1.8K | 1.2K |
| 2023 | $4.3K | $850.38 | 5.03x | $3.4K | $981.1K | 1.4K | 849 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 20.3K | $15.3M | $755.19 | 7.28x |
| 66982 | Removal of cataract with insertion of lens | 2.0K | $1.5M | $758.45 | 7.25x |
| 0191T | Internal insertion of eye fluid drainage device | 335 | $679.0K | $2.0K | 2.71x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 3.7K | $658.1K | $179.18 | 12.97x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 209 | $382.4K | $1.8K | 3.83x |
| 66250 | Revision or repair of operative wound of eye | 314 | $195.5K | $622.62 | 4.31x |
| 66170 | Creation of eye fluid drainage tract | 326 | $183.9K | $563.98 | 5.76x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 459 | $175.9K | $383.16 | 6.52x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 64 | $159.4K | $2.5K | 2.81x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.5K | $155.6K | $106.11 | 21.90x |
| 66174 | Dilation to improve eye fluid flow | 108 | $148.7K | $1.4K | 3.40x |
| 66179 | Creation of shunt to improve eye fluid flow | 98 | $136.4K | $1.4K | 2.73x |
| 66180 | Creation of shunt to improve eye fluid flow | 82 | $110.7K | $1.3K | 2.82x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1.2K | $99.3K | $79.98 | 3.44x |
| 66710 | Destruction of lens tissue using laser | 179 | $85.3K | $476.41 | 5.63x |
| 65820 | Incision to improve eye fluid flow | 84 | $77.4K | $920.88 | 3.85x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 216 | $77.1K | $357.04 | 3.08x |
| V2785 | Processing, preserving and transporting corneal tissue | 11 | $40.9K | $3.7K | 1.39x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 296 | $36.8K | $124.47 | 18.75x |
| 66987 | Complex removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 15 | $28.0K | $1.9K | 3.76x |
This provider submits charges 7.14 times higher than what Medicare actually pays.
A markup ratio of 7.14x means for every $100 Medicare pays, this provider initially charges $714. 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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