This provider's $38.7M in total Medicare payments ranks in the 99th percentile of Ambulatory Surgical Center providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $3.1K | $631.86 | 4.93x | $2.5K | $3.6M | 5.7K | 20 |
| 2015 | $4.1K | $822.53 | 4.97x | $3.3K | $3.7M | 4.5K | 22 |
| 2016 | $4.2K | $829.89 | 5.07x | $3.4K | $4.3M | 5.2K | 21 |
| 2017 | $4.3K | $926.45 | 4.61x | $3.3K | $4.5M | 4.8K | 21 |
| 2018 | $4.2K | $950.30 | 4.46x | $3.3K | $4.4M | 4.7K | 17 |
| 2019 | $4.3K | $955.40 | 4.47x | $3.3K | $4.2M | 4.4K | 20 |
| 2020 | $4.2K | $961.00 | 4.36x | $3.2K | $2.8M | 2.9K | 17 |
| 2021 | $4.1K | $971.16 | 4.21x | $3.1K | $3.8M | 4.0K | 16 |
| 2022 | $3.9K | $921.88 | 4.28x | $3.0K | $3.7M | 4.0K | 14 |
| 2023 | $3.9K | $943.96 | 4.17x | $3.0K | $3.7M | 3.9K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 24.7K | $19.4M | $783.42 | 5.10x |
| 0191T | Internal insertion of eye fluid drainage device | 2.9K | $5.7M | $2.0K | 3.48x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 7.3K | $5.4M | $740.38 | 5.40x |
| 65820 | Incision to improve eye fluid flow | 1.3K | $1.9M | $1.5K | 1.99x |
| 67041 | Removal of membrane of retina | 574 | $779.2K | $1.4K | 4.04x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 499 | $718.9K | $1.4K | 3.80x |
| 67904 | Repair of tendon of upper eyelid | 1.3K | $649.9K | $513.32 | 4.97x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 413 | $605.4K | $1.5K | 2.88x |
| 67113 | Complex repair of detached retina and drainage of eye fluid between lens and retina | 339 | $498.6K | $1.5K | 3.73x |
| 66180 | Creation of shunt to improve eye fluid flow using tissue graft | 289 | $432.4K | $1.5K | 2.34x |
| 66172 | Creation of eye fluid drainage tract for treatment of glaucoma with previous scarring | 611 | $430.4K | $704.35 | 5.54x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 282 | $402.4K | $1.4K | 2.94x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina, all of the retina | 177 | $254.1K | $1.4K | 2.94x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 87 | $233.0K | $2.7K | 3.89x |
| 66174 | Dilation to improve eye fluid flow | 96 | $144.3K | $1.5K | 2.99x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 73 | $141.6K | $1.9K | 1.28x |
| 65875 | Removal of scar tissue in eye (posterior synechiae) | 305 | $135.0K | $442.61 | 8.80x |
| 66986 | Exchange of prosthetic lens | 157 | $116.8K | $743.91 | 3.89x |
| 66850 | Aspiration of lens material by fragmenting and aspiration | 189 | $108.2K | $572.65 | 5.96x |
| 67924 | Extensive repair of turning-inward eyelid defect | 161 | $97.8K | $607.68 | 5.27x |
This provider submits charges 4.56 times higher than what Medicare actually pays.
A markup ratio of 4.56x means for every $100 Medicare pays, this provider initially charges $456. 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 |
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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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