This provider's $10.5M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
63% of their billing comes from a single procedure code (66984 — Removal of cataract with insertion of lens).
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 | $208.81 | $99.56 | 2.10x | $109.25 | $945.8K | 7.1K | 5.7K |
| 2015 | $237.74 | $95.77 | 2.48x | $141.97 | $1.1M | 8.6K | 6.7K |
| 2016 | $235.34 | $107.88 | 2.18x | $127.46 | $1.2M | 9.7K | 7.2K |
| 2017 | $236.84 | $105.75 | 2.24x | $131.09 | $1.1M | 8.5K | 6.3K |
| 2018 | $273.43 | $125.88 | 2.17x | $147.55 | $1.2M | 7.8K | 5.6K |
| 2019 | $285.94 | $131.58 | 2.17x | $154.36 | $1.2M | 7.0K | 5.2K |
| 2020 | $307.38 | $130.20 | 2.36x | $177.18 | $788.3K | 5.0K | 3.7K |
| 2021 | $320.01 | $127.80 | 2.50x | $192.21 | $1.0M | 6.3K | 4.5K |
| 2022 | $287.40 | $121.56 | 2.36x | $165.84 | $883.2K | 5.7K | 4.2K |
| 2023 | $386.80 | $151.85 | 2.55x | $234.95 | $1.0M | 6.1K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 15.0K | $6.6M | $436.08 | 2.22x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.9K | $697.2K | $242.85 | 2.40x |
| 92136 | Measurement of corneal curvature and depth of eye | 16.2K | $645.4K | $39.95 | 3.28x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 5.9K | $597.0K | $100.61 | 2.16x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 6.5K | $553.9K | $85.40 | 2.15x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.6K | $293.4K | $112.37 | 2.20x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.5K | $291.5K | $53.06 | 2.00x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.4K | $207.6K | $86.08 | 1.87x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 299 | $132.9K | $444.59 | 2.14x |
| 92134 | Diagnostic imaging of retina | 4.5K | $131.1K | $29.19 | 2.29x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 207 | $100.8K | $487.14 | 2.01x |
| 92083 | Measurement of field of vision during daylight conditions | 3.6K | $88.3K | $24.61 | 3.87x |
| 92133 | Diagnostic imaging of optic nerve of eye | 3.6K | $61.2K | $17.20 | 3.76x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 467 | $25.8K | $55.26 | 2.19x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 47 | $23.2K | $494.06 | 2.06x |
| 92082 | Measurement of field of vision during daylight conditions | 559 | $18.2K | $32.58 | 2.30x |
| 0191T | Internal insertion of eye fluid drainage device | 44 | $12.3K | $279.15 | 4.08x |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 17 | $9.2K | $540.11 | 3.33x |
| 76514 | Ultrasound of corneal structure and measurement | 969 | $6.3K | $6.53 | 3.44x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 155 | $5.9K | $38.15 | 2.15x |
This provider submits charges 2.3 times higher than what Medicare actually pays.
A markup ratio of 2.3x means for every $100 Medicare pays, this provider initially charges $230. This is higher 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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