Owners and managers of ambulatory surgery centers have seen lucrative procedures pop up only to then see Medicare and the follow-the-leader insurers slash out most of the lucre. Take cataracts and tonsillectomy and adenoidectomy, for example. Between 1990 and 2005, Medicare cut reimbursement for cataracts from $1,500 to about $684. Medicare also moved T&A from Group 5 ($717) to Group 3 ($510), a shift of two columns and nearly $200.