This provider's $6.5M in total Medicare payments ranks in the 95th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.01x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 276% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 118% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $4.4K | $768.07 | 5.70x | $3.6K | $361.8K | 616 | 585 |
| 2017 | $3.0K | $552.26 | 5.41x | $2.4K | $312.9K | 695 | 646 |
| 2018 | $3.8K | $692.13 | 5.42x | $3.1K | $681.0K | 1.3K | 1.1K |
| 2019 | $3.7K | $666.31 | 5.51x | $3.0K | $801.2K | 1.5K | 1.4K |
| 2020 | $3.9K | $733.86 | 5.27x | $3.1K | $767.9K | 1.4K | 1.3K |
| 2021 | $4.4K | $930.56 | 4.78x | $3.5K | $1.1M | 1.8K | 1.7K |
| 2022 | $4.7K | $945.84 | 4.95x | $3.7K | $1.1M | 1.6K | 1.5K |
| 2023 | $4.5K | $1.0K | 4.39x | $3.5K | $1.4M | 1.9K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 1.1K | $887.5K | $817.20 | 4.57x |
| 45380 | Biopsy of large bowel using an endoscope | 1.5K | $543.2K | $355.48 | 4.74x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 1.6K | $431.2K | $265.86 | 5.98x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 945 | $394.5K | $417.46 | 4.03x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 175 | $348.5K | $2.0K | 4.65x |
| 49505 | Repair of groin hernia patient age 5 years or older | 288 | $332.0K | $1.2K | 4.95x |
| 47562 | Removal of gallbladder using an endoscope | 168 | $308.0K | $1.8K | 4.39x |
| 36561 | Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older | 280 | $305.5K | $1.1K | 4.37x |
| 19301 | Partial removal of breast | 386 | $281.5K | $729.30 | 6.33x |
| 23430 | Anchoring of biceps tendon | 114 | $232.6K | $2.0K | 3.93x |
| 64721 | Release and/or relocation of median nerve of hand | 343 | $223.5K | $651.52 | 4.53x |
| 38525 | Biopsy or removal of lymph nodes of under the arm, open procedure | 209 | $182.4K | $872.86 | 5.72x |
| 49650 | Repair of groin hernia using an endoscope | 92 | $158.6K | $1.7K | 4.67x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 535 | $150.5K | $281.36 | 5.09x |
| 49525 | Repositioning of sliding groin hernia | 127 | $139.6K | $1.1K | 5.19x |
| 52356 | Crushing of stone in urinary duct (ureter) with stent using an endoscope | 77 | $126.6K | $1.6K | 4.04x |
| 26055 | Incision of tendon covering | 195 | $94.8K | $486.01 | 5.39x |
| 49507 | Repair of trapped groin hernia (5 years or older) | 74 | $93.3K | $1.3K | 4.52x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 28 | $92.0K | $3.3K | 3.61x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 161 | $91.6K | $568.65 | 16.29x |
This provider submits charges 5.01 times higher than what Medicare actually pays.
A markup ratio of 5.01x means for every $100 Medicare pays, this provider initially charges $501. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| River Drive Surgery Center, Llc | Elmwood Park, NJ | $75.2M | ✓ Clear |
| Essex Specialized Surgical Institute Llc | West Orange, NJ | $38.7M | ✓ Clear |
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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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