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NPI 1902877715 · Cedar Knolls, NJ · Ambulatory Surgical Clinic/Center
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Ambulatory Surgical Center Of Morris County LLC is a ambulatory surgical clinic/center provider located in Cedar Knolls, New Jersey. This profile covers 18 Medicare and 4 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 | Ambulatory Surgical Center Of Morris County LLC |
| Address | 14 Ridgedale Ave |
| City | Cedar Knolls |
| State | NJ |
| ZIP | 07927 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.8M |
| Medicaid | $923.2K |
Business/service-line profile: The center’s Medicare and Medicaid top codes are dominated by ophthalmic surgery and intraoperative ophthalmic pharmaceuticals (notably 66984, J1096, J1097), indicating the facility operates primarily as an ophthalmology-focused ambulatory surgical center that also bills for endoscopic procedures (43239) and colonoscopy-related codes. This code mix suggests routine cataract surgery with frequent use of branded ophthalmic inserts and irrigation solutions during cases, alongside a secondary service line performing upper endoscopy and some colonoscopy work.
Revenue concentration — Medicare: The top 3 Medicare codes drive concentrated revenue: the precomputed top-3 share is 68.7% of Medicare revenue, with 66984 alone accounting for $1.2M (43.1% of Medicare revenue) and two ophthalmic drug codes (J1096, J1097) contributing substantial additional shares. This concentration implies the facility’s Medicare performance is heavily dependent on cataract procedures and associated ophthalmic supplies/medications.
Revenue concentration — Medicaid: Medicaid revenue is extremely concentrated in three codes (precomputed top-3 share 98.2%), led by 66984 at $504.8K (54.7%) and 43239 at $366K (39.6%). Medicaid dollars for this provider are therefore almost entirely driven by cataract surgery and upper endoscopy services, leaving little diversification across other Medicaid-reimbursed procedures.
Payer mix and scale: Lifetime Medicare revenue ($2.8M) substantially exceeds lifetime Medicaid revenue ($923.2K), making Medicare the dominant payer by revenue for this provider. While the center does have meaningful Medicaid activity—primarily for 66984 and 43239—the overall scale of Medicaid billing is materially smaller than Medicare in absolute dollars.
Competitive standing — Medicare national position: For several high-revenue Medicare codes the provider sits at or above national median volume but is mostly characterized as a typical participant; for example, 66984 ranks #1555 of 15965 (90th percentile, described as typical) and 66982 ranks in the 97th percentile but likewise labeled typical. A notable exception is J1096 (dexamethasone lacrimal insert), which ranks #11 of 282 nationally (96th percentile) and is flagged as notably above typical national volume, indicating a relatively rare high-volume usage of this specific ophthalmic insert compared with national peers.
Competitive standing — Medicaid in-state position: On Medicaid, 66984 ranks #16 of 63 in-state (76th percentile) and 43239 ranks #99 of 284 in-state (65th percentile), both described as typical volumes for New Jersey peers; the provider is not a clear statewide dominator but is an active regional participant for cataract and upper endoscopy billing.
Operational/booking implications: The combination of high-revenue surgical codes for cataract extraction (66984) plus high-volume, low-dollar ophthalmic supply/drug codes (J1096, J1097) suggests operating room throughput is focused on high-frequency, short-stay ophthalmic cases where per-case supply/drug utilization materially increases revenue per encounter. The presence of endoscopy and colonoscopy codes on both payers shows the center schedules mixed-specialty sessions or hosts multiple service lines rather than exclusively ophthalmology.
Data pattern notes / statistical outliers: J1096 is specifically flagged as “notably above typical national volume,” marking it as an outlier in national comparisons and merits attention when benchmarking ophthalmic supply utilization. Additionally, a very large reported claim count for J2403 (65.6K claims) paired with a $1 avg paid/claim and a mid-to-low percentile rank suggests reporting or unit-of-service billing practices for small-unit ophthalmic supplies that contribute little revenue but appear frequently on claims; this pattern is operationally relevant when auditing utilization mix and supply reporting.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 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… | 1,410 | $870 | $1.2M |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | 4,200 | $100 | $420.3K |
| J1097 | phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml | 4,030 | $80 | $310.3K |
| 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… | 60 | $2,680 | $168.5K |
| 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… | 160 | $780 | $126.5K |
| 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. | 80 | $1,490 | $114.4K |
| 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. | 60 | $1,460 | $92.2K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 65,610 | $1 | $65.6K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 220 | $290 | $63.1K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 130 | $490 | $62.8K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J1096 | 3 | 20 | 860 | $100 | $162.9K |
| 66984 | 9 | 370 | 100 | $670 | $141.2K |
| J1097 | 3 | 20 | 860 | $80 | $123.6K |
| 66991 | 7 | 50 | 30 | $2,020 | $82.9K |
| J2403 | 4 | 10 | 122,400 | $1 | $73.5K |
| 65820 | 9 | 60 | 30 | $1,130 | $50.9K |
| 66982 | 7 | 160 | 30 | $740 | $40.7K |
| 66174 | 5 | 40 | 30 | $860 | $34.5K |
| 45385 | 70 | 560 | 50 | $320 | $25.4K |
| 45380 | 90 | 590 | 60 | $230 | $21.3K |
Showing 1–10 of 18
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.
4 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… | 830 | $610 | $504.8K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 730 | $500 | $366K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 80 | $450 | $35.9K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 50 | $330 | $16.3K |
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
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 99 | 280 | 360 | $560 | $567.5K |
| 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… | 16 | 60 | 110 | $370 | $327.3K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 124 | 170 | 200 | $470 | $313.6K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 68 | 110 | 250 | $540 | $292.2K |
Other providers in the same ZIP code as Ambulatory Surgical Center Of Morris County LLC, ranked by combined Medicare and Medicaid revenue.
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