This provider's $75.2M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.73x is significantly above the specialty median of 6.1x.
63% 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 | $3.0K | $545.37 | 5.49x | $2.4K | $7.9M | 14.5K | 25 |
| 2015 | $3.9K | $705.05 | 5.55x | $3.2K | $7.6M | 10.7K | 22 |
| 2016 | $3.9K | $721.94 | 5.42x | $3.2K | $7.9M | 10.9K | 20 |
| 2017 | $4.1K | $777.04 | 5.22x | $3.3K | $8.0M | 10.3K | 21 |
| 2018 | $4.1K | $790.78 | 5.21x | $3.3K | $8.0M | 10.1K | 17 |
| 2019 | $4.2K | $803.20 | 5.17x | $3.3K | $7.5M | 9.3K | 14 |
| 2020 | $6.8K | $859.91 | 7.86x | $5.9K | $4.8M | 5.6K | 15 |
| 2021 | $6.6K | $745.79 | 8.86x | $5.9K | $7.9M | 10.6K | 17 |
| 2022 | $6.9K | $747.23 | 9.29x | $6.2K | $7.6M | 10.2K | 17 |
| 2023 | $7.8K | $813.20 | 9.60x | $7.0K | $8.0M | 9.9K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 53.3K | $46.5M | $872.46 | 7.23x |
| 0191T | Internal insertion of eye fluid drainage device | 4.0K | $8.6M | $2.1K | 2.99x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 8.8K | $7.6M | $857.43 | 7.06x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 775 | $2.3M | $3.0K | 4.22x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 9.7K | $2.1M | $220.32 | 12.11x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 9.0K | $946.4K | $104.86 | 1.27x |
| 67400 | Exploration of cavity behind eye | 1.0K | $914.7K | $882.95 | 6.22x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 1.8K | $787.8K | $435.26 | 5.16x |
| 66988 | Removal of cataract with insertion of prosthetic lens and laser treatment to decrease fluid production in eye | 462 | $640.8K | $1.4K | 5.33x |
| 67904 | Repair of tendon of upper eyelid | 1.5K | $571.6K | $393.92 | 11.38x |
| 66174 | Dilation of fluid outflow drainage within eye | 365 | $468.5K | $1.3K | 10.49x |
| 65820 | Incision to improve eye fluid flow | 314 | $440.7K | $1.4K | 10.17x |
| 68700 | Plastic repair of tear duct | 1.1K | $414.9K | $385.92 | 7.17x |
| 15732 | Muscle flap wound repair at head and neck | 691 | $414.4K | $599.71 | 4.03x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 110 | $325.7K | $3.0K | 4.23x |
| 67917 | Extensive repair of turning-outward eyelid defect | 657 | $302.5K | $460.45 | 6.44x |
| 66761 | Creation of eye fluid drainage tracts in iris using a laser, per session | 1.7K | $268.0K | $161.81 | 16.95x |
| 65855 | Laser repair to improve eye fluid flow | 1.7K | $237.4K | $136.96 | 24.96x |
| 65426 | Removal or relocation of corneal conjunctiva with graft | 291 | $169.7K | $583.28 | 6.36x |
| 66710 | Destruction of lens tissue using laser | 213 | $134.4K | $631.08 | 6.17x |
This provider submits charges 6.73 times higher than what Medicare actually pays.
A markup ratio of 6.73x means for every $100 Medicare pays, this provider initially charges $673. 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 |
|---|---|---|---|
| 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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