This provider's $8.1M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 113% from 2014 to 2023.
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 | $275.21 | $183.69 | 1.50x | $91.52 | $431.9K | 5.2K | 2.5K |
| 2015 | $398.85 | $240.95 | 1.66x | $157.90 | $622.4K | 5.7K | 2.4K |
| 2016 | $283.73 | $203.83 | 1.39x | $79.90 | $766.5K | 6.9K | 2.5K |
| 2017 | $294.70 | $212.03 | 1.39x | $82.67 | $932.8K | 7.4K | 2.6K |
| 2018 | $194.91 | $136.72 | 1.43x | $58.19 | $661.7K | 7.1K | 2.9K |
| 2019 | $272.38 | $199.61 | 1.36x | $72.77 | $828.0K | 6.5K | 2.8K |
| 2020 | $259.03 | $177.59 | 1.46x | $81.44 | $876.7K | 5.7K | 2.4K |
| 2021 | $336.29 | $242.48 | 1.39x | $93.81 | $1.1M | 6.9K | 3.3K |
| 2022 | $283.13 | $195.15 | 1.45x | $87.98 | $1.0M | 7.0K | 3.5K |
| 2023 | $300.33 | $198.80 | 1.51x | $101.53 | $920.0K | 7.2K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4.1K | $3.0M | $731.60 | 1.49x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 14.2K | $1.3M | $92.03 | 1.41x |
| J2778 | Injection, ranibizumab, 0.1 mg | 5.1K | $1.3M | $255.05 | 1.73x |
| 67028 | Injection of drug into eye | 13.0K | $1.1M | $87.40 | 1.56x |
| 92134 | Diagnostic imaging of retina | 20.1K | $655.1K | $32.58 | 1.40x |
| J9035 | Injection, bevacizumab, 10 mg | 3.3K | $179.2K | $54.10 | 1.48x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.2K | $107.7K | $87.23 | 1.43x |
| 67042 | Removal of membrane from the retina, pars plana approach | 113 | $104.4K | $924.24 | 1.38x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.4K | $96.7K | $69.06 | 1.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 874 | $61.3K | $70.19 | 1.30x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 112 | $48.4K | $431.92 | 1.44x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 346 | $42.6K | $123.17 | 1.47x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 539 | $40.9K | $75.91 | 1.56x |
| 92250 | Photography of the retina | 554 | $27.7K | $49.99 | 1.59x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 150 | $17.6K | $117.53 | 1.98x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 313 | $9.1K | $29.08 | 1.47x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 53 | $7.2K | $136.15 | 1.29x |
| 92225 | Examination of eye by ophthalmoscope with retinal drawing | 197 | $4.2K | $21.30 | 1.70x |
| 76512 | Ultrasound of eye disease, growth, or structure | 46 | $2.2K | $47.13 | 1.60x |
| 92083 | Measurement of field of vision during daylight conditions | 20 | $920.06 | $46.00 | 1.45x |
This provider submits charges 1.51 times higher than what Medicare actually pays.
A markup ratio of 1.51x means for every $100 Medicare pays, this provider initially charges $151. This is lower than the national average.
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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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