This provider's $11.8M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.14x is significantly above the specialty median of 6.1x.
74% 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 | $4.7K | $896.93 | 5.22x | $3.8K | $1.1M | 1.4K | 886 |
| 2015 | $5.9K | $898.68 | 6.55x | $5.0K | $981.6K | 1.3K | 849 |
| 2016 | $5.9K | $903.74 | 6.51x | $5.0K | $1.1M | 1.5K | 949 |
| 2017 | $7.4K | $1.3K | 5.72x | $6.1K | $1.2M | 1.5K | 912 |
| 2018 | $7.6K | $1.3K | 5.66x | $6.3K | $1.2M | 1.5K | 908 |
| 2019 | $6.0K | $1.1K | 5.57x | $4.9K | $1.3M | 1.6K | 985 |
| 2020 | $5.1K | $935.41 | 5.44x | $4.2K | $901.1K | 1.1K | 679 |
| 2021 | $5.3K | $989.30 | 5.33x | $4.3K | $1.3M | 1.7K | 1.1K |
| 2022 | $6.1K | $1.0K | 5.86x | $5.1K | $1.4M | 2.2K | 1.4K |
| 2023 | $6.5K | $1.3K | 5.14x | $5.2K | $1.5M | 2.3K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 12.1K | $8.7M | $720.63 | 6.41x |
| 0191T | Internal insertion of eye fluid drainage device | 579 | $1.0M | $1.8K | 4.56x |
| 65820 | Incision to improve eye fluid flow | 503 | $567.5K | $1.1K | 4.16x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 187 | $463.1K | $2.5K | 6.39x |
| 66174 | Dilation to improve eye fluid flow | 219 | $287.0K | $1.3K | 6.23x |
| 66982 | Removal of cataract with insertion of lens | 416 | $285.8K | $687.05 | 6.69x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1.9K | $143.9K | $77.38 | 7.26x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 70 | $129.4K | $1.8K | 6.38x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 42 | $80.9K | $1.9K | 5.92x |
| 66183 | Insertion of eye fluid drainage device | 15 | $33.3K | $2.2K | 3.68x |
| J9280 | Injection, mitomycin, 5 mg | 33 | $1.2K | $37.79 | 1.27x |
This provider submits charges 6.14 times higher than what Medicare actually pays.
A markup ratio of 6.14x means for every $100 Medicare pays, this provider initially charges $614. 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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