This provider's $29.4M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
77% 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 | $1.7K | $504.39 | 3.37x | $1.2K | $3.0M | 4.8K | 3.5K |
| 2015 | $1.6K | $471.76 | 3.46x | $1.2K | $2.9M | 4.8K | 3.4K |
| 2016 | $1.6K | $487.93 | 3.36x | $1.1K | $3.1M | 5.1K | 3.6K |
| 2017 | $1.7K | $542.42 | 3.18x | $1.2K | $3.3M | 5.1K | 3.7K |
| 2018 | $1.8K | $656.01 | 2.82x | $1.2K | $3.2M | 4.7K | 3.3K |
| 2019 | $1.9K | $797.83 | 2.43x | $1.1K | $3.1M | 4.5K | 3.1K |
| 2020 | $1.5K | $634.18 | 2.43x | $907.36 | $2.2M | 2.9K | 2.1K |
| 2021 | $1.9K | $916.63 | 2.12x | $1.0K | $2.9M | 3.6K | 2.5K |
| 2022 | $2.0K | $945.79 | 2.13x | $1.1K | $2.8M | 3.7K | 2.6K |
| 2023 | $2.2K | $1.1K | 2.08x | $1.1K | $2.8M | 3.5K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 28.1K | $22.1M | $788.73 | 3.12x |
| 66982 | Removal of cataract with insertion of lens | 2.4K | $1.9M | $799.66 | 3.08x |
| 0191T | Internal insertion of eye fluid drainage device | 607 | $1.2M | $1.9K | 1.36x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 4.9K | $946.9K | $192.58 | 5.19x |
| 66170 | Creation of eye fluid drainage tract | 610 | $335.7K | $550.32 | 4.36x |
| V2785 | Processing, preserving and transporting corneal tissue | 84 | $301.6K | $3.6K | 1.27x |
| 67904 | Repair of tendon of upper eyelid | 606 | $300.9K | $496.46 | 2.72x |
| 65820 | Incision to improve eye fluid flow | 198 | $297.0K | $1.5K | 1.60x |
| 66180 | Creation of shunt to improve eye fluid flow | 128 | $235.4K | $1.8K | 1.35x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 82 | $216.5K | $2.6K | 1.46x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 419 | $151.9K | $362.62 | 1.28x |
| 64721 | Release and/or relocation of median nerve of hand | 228 | $127.4K | $558.93 | 4.62x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.1K | $126.5K | $116.45 | 9.45x |
| 66174 | Dilation to improve eye fluid flow | 80 | $122.8K | $1.5K | 1.56x |
| 65756 | Transplant of outer layer of corneal tissue | 75 | $116.2K | $1.5K | 2.00x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 629 | $88.7K | $141.06 | 8.51x |
| 67917 | Extensive repair of turning-outward eyelid defect | 194 | $83.9K | $432.57 | 5.55x |
| 0474T | Insertion of drainage device and creation of fluid reservoir in front chamber of eye | 40 | $79.1K | $2.0K | 1.28x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 159 | $78.7K | $494.97 | 2.46x |
| 26055 | Incision of tendon covering | 158 | $75.7K | $478.82 | 3.80x |
This provider submits charges 3.1 times higher than what Medicare actually pays.
A markup ratio of 3.1x means for every $100 Medicare pays, this provider initially charges $310. 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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