This provider's $32.6M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
68% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of prosthetic lens).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 64% in 2021
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 | $2.5K | $814.63 | 3.02x | $1.6K | $2.6M | 3.2K | 7 |
| 2015 | $2.4K | $856.14 | 2.79x | $1.5K | $3.0M | 3.5K | 7 |
| 2016 | $2.4K | $876.34 | 2.71x | $1.5K | $3.4M | 3.9K | 7 |
| 2017 | $2.4K | $893.80 | 2.68x | $1.5K | $3.2M | 3.6K | 9 |
| 2018 | $2.5K | $951.58 | 2.66x | $1.6K | $3.4M | 3.5K | 6 |
| 2019 | $760.72 | $285.54 | 2.66x | $475.18 | $3.2M | 11.1K | 7 |
| 2020 | $1.5K | $629.82 | 2.44x | $907.42 | $2.3M | 3.7K | 8 |
| 2021 | $795.21 | $342.69 | 2.32x | $452.52 | $3.8M | 11.1K | 10 |
| 2022 | $776.01 | $333.03 | 2.33x | $442.98 | $3.8M | 11.4K | 9 |
| 2023 | $271.15 | $118.08 | 2.30x | $153.07 | $3.9M | 32.8K | 11 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 26.3K | $22.1M | $839.85 | 2.93x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 26.7K | $2.8M | $104.05 | 1.27x |
| 0191T | Internal insertion of eye fluid drainage device | 1.2K | $2.5M | $2.1K | 1.51x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 2.9K | $2.4M | $833.97 | 2.95x |
| V2785 | Processing, preserving and transporting corneal tissue | 186 | $583.8K | $3.1K | 1.28x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 209 | $552.7K | $2.6K | 1.52x |
| 65820 | Incision to improve eye fluid flow | 241 | $320.5K | $1.3K | 1.93x |
| 65756 | Transplantation of outer layer of corneal tissue | 177 | $274.4K | $1.6K | 1.54x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 105 | $209.5K | $2.0K | 1.49x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 513 | $194.0K | $378.24 | 1.45x |
| 0449T | Insertion of initial aqueous fluid drainage device into eye | 74 | $174.8K | $2.4K | 1.48x |
| 66174 | Dilation of fluid outflow drainage within eye | 183 | $160.4K | $876.34 | 2.88x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 37 | $98.5K | $2.7K | 1.49x |
| 66170 | Creation of eye fluid drainage tract for treatment of glaucoma | 111 | $85.0K | $765.44 | 3.08x |
| 66183 | Insertion of eye fluid drainage device | 23 | $54.4K | $2.4K | 1.48x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 156 | $33.2K | $212.52 | 4.29x |
| 67255 | Repair of defect of sclera with graft | 52 | $24.0K | $461.64 | 2.60x |
| 66250 | Revision or repair of operative wound of eye | 27 | $18.3K | $678.29 | 2.09x |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 20.8K | $11.6K | $0.56 | 1.28x |
| 66710 | Destruction of lens tissue using laser | 16 | $11.4K | $709.77 | 1.69x |
This provider submits charges 2.57 times higher than what Medicare actually pays.
A markup ratio of 2.57x means for every $100 Medicare pays, this provider initially charges $257. 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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