This provider's $13.8M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $636.13 | $187.22 | 3.40x | $448.91 | $2.2M | 13.2K | 11.5K |
| 2015 | $625.20 | $190.22 | 3.29x | $434.98 | $2.0M | 14.2K | 12.3K |
| 2016 | $502.53 | $155.40 | 3.23x | $347.13 | $1.6M | 13.4K | 10.9K |
| 2017 | $535.78 | $161.09 | 3.33x | $374.69 | $1.6M | 14.4K | 11.1K |
| 2018 | $493.51 | $166.43 | 2.97x | $327.08 | $1.4M | 12.5K | 9.5K |
| 2019 | $443.44 | $162.38 | 2.73x | $281.06 | $1.2M | 11.6K | 8.7K |
| 2020 | $422.45 | $168.70 | 2.50x | $253.75 | $899.7K | 8.3K | 6.4K |
| 2021 | $383.27 | $180.49 | 2.12x | $202.78 | $976.5K | 8.3K | 6.2K |
| 2022 | $387.97 | $173.76 | 2.23x | $214.21 | $1.1M | 8.7K | 6.4K |
| 2023 | $427.65 | $173.67 | 2.46x | $253.98 | $872.2K | 7.6K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 68320 | Repair of conjunctiva | 4.2K | $2.9M | $699.51 | 2.06x |
| 67924 | Repair of turning-inward eyelid defect | 3.4K | $2.0M | $592.45 | 1.97x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 7.3K | $1.6M | $220.65 | 4.61x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 18.8K | $1.3M | $69.32 | 1.92x |
| 67950 | Enlargement of eyelid margin | 4.2K | $1.3M | $303.96 | 4.54x |
| 92250 | Photography of the retina | 11.1K | $478.9K | $43.22 | 2.16x |
| 67904 | Repair of tendon of upper eyelid | 588 | $453.7K | $771.66 | 2.22x |
| 92083 | Measurement of field of vision during daylight conditions | 8.6K | $403.8K | $46.95 | 2.29x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.3K | $354.8K | $56.59 | 1.91x |
| 68761 | Closure of tear duct opening using plug | 4.7K | $353.1K | $75.65 | 3.11x |
| 92284 | Evaluation of eye adaptation to light and dark (rods and cones) | 6.3K | $321.4K | $51.31 | 1.87x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 3.3K | $313.5K | $95.47 | 1.91x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.0K | $287.5K | $274.29 | 3.42x |
| 67825 | Removal of eyelashes | 3.4K | $273.3K | $79.51 | 2.58x |
| 67961 | Removal of up to one-fourth of the eyelid involving lid margin | 1.3K | $271.6K | $205.93 | 5.94x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 1.2K | $253.8K | $213.28 | 4.83x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.6K | $181.7K | $110.64 | 1.87x |
| 92133 | Diagnostic imaging of optic nerve of eye | 6.1K | $181.0K | $29.83 | 4.21x |
| 92132 | Diagnostic imaging of eyes | 6.0K | $137.9K | $23.18 | 4.83x |
| 92285 | Photography of content of eyes | 8.6K | $129.6K | $15.07 | 4.11x |
This provider submits charges 2.85 times higher than what Medicare actually pays.
A markup ratio of 2.85x means for every $100 Medicare pays, this provider initially charges $285. 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 Ophthalmology providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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