This provider's $19.0M in total Medicare payments ranks in the 98th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 5.43x is significantly above the specialty median of 6.1x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 57% 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 | $2.1K | $461.93 | 4.54x | $1.6K | $1.5M | 3.0K | 2.5K |
| 2015 | $1.9K | $358.77 | 5.33x | $1.6K | $1.6M | 3.2K | 2.7K |
| 2016 | $2.0K | $442.41 | 4.45x | $1.5K | $1.9M | 3.7K | 3.0K |
| 2017 | $1.9K | $438.59 | 4.38x | $1.5K | $2.3M | 4.1K | 3.2K |
| 2018 | $2.4K | $461.11 | 5.22x | $1.9K | $2.1M | 3.4K | 2.7K |
| 2019 | $3.0K | $460.72 | 6.55x | $2.6K | $1.9M | 3.5K | 2.8K |
| 2020 | $3.4K | $569.50 | 6.01x | $2.9K | $1.3M | 2.2K | 1.8K |
| 2021 | $3.1K | $511.20 | 6.07x | $2.6K | $2.0M | 3.9K | 2.9K |
| 2022 | $3.2K | $591.54 | 5.34x | $2.6K | $2.0M | 4.2K | 3.0K |
| 2023 | $3.2K | $591.48 | 5.43x | $2.6K | $2.2M | 4.8K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 13.0K | $10.4M | $801.53 | 5.56x |
| 0191T | Internal insertion of eye fluid drainage device | 611 | $1.3M | $2.1K | 2.50x |
| 66982 | Removal of cataract with insertion of lens | 1.2K | $964.7K | $773.00 | 5.38x |
| 43239 | Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope | 2.7K | $796.2K | $292.08 | 10.26x |
| 45380 | Biopsy of large bowel using an endoscope | 2.0K | $727.1K | $361.91 | 6.39x |
| 45385 | Removal of polyps or growths of large bowel using an endoscope | 1.6K | $614.1K | $394.38 | 6.51x |
| C9447 | Injection, phenylephrine and ketorolac, 4 ml vial | 1.6K | $592.6K | $373.66 | 1.32x |
| 66174 | Dilation to improve eye fluid flow | 338 | $509.0K | $1.5K | 3.59x |
| 45378 | Diagnostic examination of large bowel using an endoscope | 1.6K | $500.4K | $320.97 | 6.62x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.2K | $443.5K | $202.23 | 8.27x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 111 | $296.8K | $2.7K | 2.61x |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 674 | $264.7K | $392.76 | 7.54x |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 2.3K | $240.0K | $102.63 | 3.52x |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 3.0K | $234.7K | $79.00 | 1.52x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 823 | $227.9K | $276.95 | 7.28x |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 459 | $181.7K | $395.87 | 7.52x |
| 65820 | Incision to improve eye fluid flow | 117 | $153.8K | $1.3K | 1.81x |
| 62311 | Injections of substances into lower or sacral spine | 367 | $107.5K | $292.78 | 3.33x |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance | 121 | $76.7K | $633.93 | 4.92x |
| 67010 | Partial removal of eye fluid between the lens and retina | 101 | $67.9K | $671.98 | 3.91x |
This provider submits charges 5.43 times higher than what Medicare actually pays.
A markup ratio of 5.43x means for every $100 Medicare pays, this provider initially charges $543. 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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