This provider's $30.4M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 8.89x is significantly above the specialty median of 6.1x.
66% 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 52% 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 | $6.3K | $816.67 | 7.68x | $5.5K | $3.1M | 3.8K | 15 |
| 2015 | $6.5K | $829.63 | 7.82x | $5.7K | $3.2M | 3.8K | 16 |
| 2016 | $6.7K | $820.25 | 8.20x | $5.9K | $3.2M | 3.9K | 18 |
| 2017 | $7.8K | $891.83 | 8.70x | $6.9K | $3.3M | 3.7K | 16 |
| 2018 | $8.1K | $883.04 | 9.15x | $7.2K | $3.3M | 3.8K | 14 |
| 2019 | $8.2K | $843.78 | 9.74x | $7.4K | $2.9M | 3.5K | 13 |
| 2020 | $8.5K | $858.21 | 9.87x | $7.6K | $2.0M | 2.4K | 10 |
| 2021 | $8.2K | $872.16 | 9.36x | $7.3K | $3.1M | 3.6K | 13 |
| 2022 | $6.6K | $714.89 | 9.27x | $5.9K | $3.0M | 4.2K | 13 |
| 2023 | $5.5K | $576.71 | 9.51x | $4.9K | $3.2M | 5.6K | 12 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 22.5K | $19.8M | $877.19 | 9.59x |
| 0191T | Internal insertion of eye fluid drainage device | 1.3K | $2.8M | $2.1K | 5.47x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 2.8K | $2.3M | $850.19 | 9.38x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 488 | $715.2K | $1.5K | 7.25x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 236 | $702.8K | $3.0K | 4.19x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 3.0K | $667.0K | $223.09 | 16.28x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 407 | $652.5K | $1.6K | 6.69x |
| 67041 | Removal of membrane of retina | 434 | $625.7K | $1.4K | 7.60x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 3.4K | $340.7K | $101.51 | 1.37x |
| 67108 | Repair of detached retina and drainage of eye fluid between lens and retina, with removal of vitreous fluid | 195 | $305.6K | $1.6K | 5.45x |
| 65820 | Incision to improve eye fluid flow | 189 | $302.5K | $1.6K | 8.65x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 117 | $182.1K | $1.6K | 5.64x |
| 66761 | Creation of eye fluid drainage tracts in iris using a laser, per session | 756 | $124.5K | $164.71 | 22.25x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 1.4K | $107.1K | $77.96 | 1.46x |
| 67039 | Laser destruction of eye fluid (vitreous) between the lens and retina | 66 | $99.6K | $1.5K | 5.95x |
| 65756 | Transplantation of outer layer of corneal tissue | 58 | $99.5K | $1.7K | 7.20x |
| 66986 | Exchange of lens prosthesis | 162 | $87.4K | $539.51 | 11.93x |
| 67113 | Repair of detached retina and drainage of eye fluid between lens and retina | 42 | $66.0K | $1.6K | 6.82x |
| V2785 | Processing, preserving and transporting corneal tissue | 15 | $54.8K | $3.7K | 1.52x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 18 | $54.3K | $3.0K | 4.04x |
This provider submits charges 8.89 times higher than what Medicare actually pays.
A markup ratio of 8.89x means for every $100 Medicare pays, this provider initially charges $889. 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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