This provider's $3.5M in total Medicare payments ranks in the 91th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.74x is significantly above the specialty median of 6.1x.
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 | $3.2K | $611.36 | 5.27x | $2.6K | $299.0K | 590 | 581 |
| 2015 | $3.1K | $612.47 | 5.04x | $2.5K | $411.1K | 746 | 724 |
| 2016 | $3.4K | $732.24 | 4.64x | $2.7K | $434.1K | 733 | 721 |
| 2017 | $3.3K | $683.82 | 4.89x | $2.7K | $370.3K | 676 | 665 |
| 2018 | $3.2K | $696.69 | 4.61x | $2.5K | $352.6K | 656 | 646 |
| 2019 | $3.2K | $617.99 | 5.23x | $2.6K | $296.2K | 570 | 554 |
| 2020 | $3.2K | $624.81 | 5.06x | $2.5K | $236.3K | 433 | 431 |
| 2021 | $3.2K | $642.64 | 4.96x | $2.5K | $347.0K | 715 | 710 |
| 2022 | $3.1K | $560.87 | 5.49x | $2.5K | $364.5K | 776 | 768 |
| 2023 | $3.3K | $595.52 | 5.51x | $2.7K | $411.5K | 808 | 796 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 45380 | Biopsy of large bowel using an endoscope | 1.5K | $567.1K | $372.10 | 7.37x |
| 19301 | Partial removal of breast | 761 | $526.3K | $691.63 | 5.44x |
| 38525 | Biopsy or removal of lymph nodes of under the arm, open procedure | 497 | $472.3K | $950.25 | 3.66x |
| 58558 | Biopsy and/or removal of polyp of the uterus using an endoscope | 463 | $450.9K | $973.95 | 3.80x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 1.4K | $399.8K | $275.90 | 9.32x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 479 | $195.9K | $408.88 | 6.16x |
| 19125 | Removal of breast growth, open procedure | 201 | $183.7K | $913.88 | 4.25x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 403 | $125.3K | $310.85 | 8.10x |
| 64721 | Release and/or relocation of median nerve of hand | 165 | $103.9K | $629.68 | 4.83x |
| 19120 | Removal of 1 or more breast growth, open procedure | 92 | $88.4K | $961.34 | 4.23x |
| 57288 | Creation of sling around bladder canal (urethra) to control leakage | 61 | $88.3K | $1.4K | 2.34x |
| 28285 | Correction of toe joint deformity | 128 | $82.8K | $646.59 | 5.24x |
| 26055 | Incision of tendon covering | 95 | $46.3K | $486.97 | 7.09x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 111 | $42.2K | $380.19 | 7.51x |
| 57240 | Repair of herniated bladder into vaginal wall | 25 | $28.7K | $1.1K | 5.04x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 54 | $23.5K | $434.66 | 5.61x |
| 19303 | Total removal of breast | 12 | $18.8K | $1.6K | 2.69x |
| 69436 | Incision of eardrum with insertion of eardrum tube under general anesthesia | 30 | $15.1K | $503.85 | 8.45x |
| 57260 | Plastic repair of vagina and tissue separating vagina, rectum, and bladder | 11 | $13.0K | $1.2K | 5.10x |
| 52287 | Examination with injections of chemical for destruction of bladder using an endoscope | 19 | $10.9K | $573.82 | 5.39x |
This provider submits charges 5.74 times higher than what Medicare actually pays.
A markup ratio of 5.74x means for every $100 Medicare pays, this provider initially charges $574. 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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