This provider's $9.9M in total Medicare payments ranks in the 97th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.92x 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 | $1.6K | $282.61 | 5.70x | $1.3K | $932.5K | 3.0K | 3.0K |
| 2015 | $1.6K | $290.22 | 5.42x | $1.3K | $1.0M | 3.1K | 3.1K |
| 2016 | $2.2K | $326.36 | 6.61x | $1.8K | $1.1M | 3.1K | 3.1K |
| 2017 | $2.1K | $315.64 | 6.76x | $1.8K | $1000.0K | 3.1K | 3.0K |
| 2018 | $2.2K | $321.23 | 6.83x | $1.9K | $1.0M | 3.1K | 3.1K |
| 2019 | $2.2K | $325.92 | 6.76x | $1.9K | $968.6K | 2.8K | 2.8K |
| 2020 | $2.3K | $331.03 | 7.03x | $2.0K | $748.6K | 2.2K | 2.2K |
| 2021 | $3.0K | $369.88 | 7.99x | $2.6K | $1.0M | 2.9K | 2.8K |
| 2022 | $3.0K | $360.54 | 8.20x | $2.6K | $1.0M | 2.9K | 2.8K |
| 2023 | $2.9K | $371.13 | 7.84x | $2.5K | $1.1M | 2.8K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 8.3K | $2.3M | $278.51 | 7.67x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 5.1K | $2.1M | $408.78 | 5.53x |
| 45380 | Biopsy of large bowel using an endoscope | 5.5K | $1.9M | $353.38 | 7.34x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 4.2K | $1.6M | $375.35 | 6.70x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 2.8K | $1.0M | $369.45 | 6.79x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 2.3K | $701.2K | $302.26 | 8.17x |
| 43249 | Balloon dilation of esophagus using an endoscope | 232 | $122.7K | $529.04 | 3.88x |
| 45331 | Biopsy of large bowel using an endoscope | 201 | $53.8K | $267.62 | 6.80x |
| 45381 | Injections of large bowel using an endoscope | 165 | $45.7K | $276.87 | 9.91x |
| 45330 | Diagnostic examination of large bowel using an endoscope | 136 | $13.1K | $96.56 | 17.39x |
| 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 24 | $7.0K | $289.82 | 5.16x |
| 46221 | Removal of external hemorrhoids by rubber banding | 16 | $1.9K | $120.61 | 20.73x |
| G0104 | Colorectal cancer screening; flexible sigmoidoscopy | 13 | $1.4K | $104.66 | 11.94x |
This provider submits charges 6.92 times higher than what Medicare actually pays.
A markup ratio of 6.92x means for every $100 Medicare pays, this provider initially charges $692. 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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