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NPI 1336138635 · North Brunswick, NJ · Ambulatory Surgical Clinic/Center
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Eye Surgical Specialists Of New Jersey P A is a ambulatory surgical clinic/center provider located in North Brunswick, New Jersey. This profile covers 12 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Eye Surgical Specialists Of New Jersey P A |
| Address | 107 N Center Dr |
| City | North Brunswick |
| State | NJ |
| ZIP | 08902 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | October 19, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.9M |
| Medicaid | $25.9K |
This provider operates as an Ambulatory Surgical Clinic/Center with a clear surgical ophthalmology profile: the Medicare top codes are dominated by cataract and intraocular lens procedures (66984, 66982, 66991) and high-volume use of a postoperative ophthalmic drug (J1096), consistent with a surgical cataract center that also administers or dispenses in-office lacrimal inserts. The presence of multiple glaucoma drainage and device codes (65820, 66183, 66180, 66174, 66170) alongside the cataract mix indicates routine management of coexisting glaucoma in a surgical setting rather than a general ophthalmology clinic.
Revenue is highly concentrated in a small number of procedures on Medicare: the precomputed top 3 Medicare codes account for 84.5% of this provider's total Medicare revenue, with 66984 alone generating $2.1M (54.5% of Medicare revenue). This concentration implies that outcomes to payer spend or utilization reviews will hinge largely on a few high-revenue services rather than a broad service mix.
The payer mix is sharply skewed toward Medicare: lifetime Medicare revenue is $3.9M compared with just $25.9K in Medicaid, indicating Medicare is the overwhelmingly dominant payer for this entity. Medicaid activity is effectively single-code and de minimis relative to Medicare, so analyses of practice patterns or financial performance should treat this as a predominantly Medicare-serving surgical center.
On Medicare competitiveness, several codes show unusually high national standing: 66984 ranks #724 of 15965 providers (95th percentile) and 66982 ranks in the 99th percentile, which together position the provider as a high-volume national outlier for standard and complex cataract procedures. The provider also ranks highly for 66991 (95th percentile) and 65820 (98th percentile), reinforcing that this center reports materially above-typical national volumes for key cataract and pediatric glaucoma incision procedures.
J1096 (dexamethasone lacrimal ophthalmic insert) is an extreme outlier in national comparison: 9K claims produced $889.9K in Medicare revenue and the provider ranks #1 of 282 (100th percentile), signaling atypically high dispensing or in-office use of this product relative to peers. That code alone represents $889.9K (22.9% of Medicare revenue), making it a major non-procedural revenue driver and a focal point for utilization or supply-chain review.
Medicaid activity is concentrated and modest: all Medicaid revenue ($25.9K) is from 66984 (44 claims, $589 avg paid/claim), and the provider ranks #42 of 63 in-state (34th percentile) for that code. In-state, the provider is a typical, not dominant, Medicaid cataract supplier, so Medicaid patterns do not mirror the provider's high Medicare volume and appear operationally insignificant by comparison.
Some glaucoma device and drainage procedure codes show only typical or unremarkable volumes nationally (for example, 66183 at the 59th percentile, 66989 at the 38th percentile, 66180 at the 49th percentile), suggesting that while glaucoma procedures are present in the mix, they are not uniformly high-volume outliers. This mixed profile—very high-volume cataract and insert dispensing alongside ordinary-volume glaucoma device reporting—indicates specialization focused on cataract surgery with adjunct glaucoma management.
The provider’s tenure is long-standing: NPI enumerated (registered) on 2005-10-19 (~21 years ago), which supports interpreting these patterns as established practice behavior rather than a short-term anomaly. Given the long registration period combined with concentrated Medicare revenue, payers should prioritize review of the high-volume cataract and J1096 activity when benchmarking or auditing this facility.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 2,420 | $880 | $2.1M |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 8,990 | $100 | $889.9K |
| 66991 | The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in… | 100 | $2,670 | $275.1K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 260 | $880 | $224.9K |
| 65820 | The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma. | 140 | $1,180 | $168.6K |
| 66183 | The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma. | 20 | $2,360 | $54.4K |
| 66989 | The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction using complex techniques and devices. The provider also inserts one or more anterior… | 20 | $2,680 | $48.2K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 20 | $2,020 | $34.3K |
| 66174 | The provider expands the aqueous outflow (drainage) canal of the eye to help relieve pressure in the eye. The procedure does not include leaving a device or stent in place. | 30 | $1,010 | $27.3K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 20,800 | $1 | $20.8K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 1 | 20 | 860 | $100 | $162.9K |
| 66984 | 2 | 370 | 100 | $670 | $141.2K |
| 66991 | 4 | 50 | 30 | $2,020 | $82.9K |
| 66989 | 4 | 10 | 30 | $2,250 | $74.3K |
| J2403 | 5 | 10 | 122,400 | $1 | $73.5K |
| 66183 | 3 | 10 | 20 | $1,580 | $59.9K |
| 65820 | 3 | 60 | 30 | $1,130 | $50.9K |
| 66982 | 6 | 160 | 30 | $740 | $40.7K |
| 66174 | 22 | 40 | 30 | $860 | $34.5K |
| 66250 | 2 | 10 | 20 | $670 | $32.6K |
Showing 1–10 of 12
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 40 | $590 | $25.9K |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 42 | 60 | 110 | $370 | $327.3K |
Other providers in the same ZIP code as Eye Surgical Specialists Of New Jersey P A, ranked by combined Medicare and Medicaid revenue.
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