This provider's $11.6M in total Medicare payments ranks in the 98th 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 | $186.50 | $120.87 | 1.54x | $65.63 | $1.2M | 8.1K | 6.5K |
| 2015 | $208.44 | $130.14 | 1.60x | $78.30 | $1.1M | 7.6K | 6.0K |
| 2016 | $260.77 | $166.82 | 1.56x | $93.95 | $1.2M | 8.1K | 6.2K |
| 2017 | $326.87 | $171.58 | 1.91x | $155.29 | $1.2M | 7.2K | 5.5K |
| 2018 | $220.70 | $125.61 | 1.76x | $95.09 | $1.2M | 7.5K | 5.8K |
| 2019 | $229.08 | $134.57 | 1.70x | $94.51 | $1.2M | 7.3K | 5.5K |
| 2020 | $254.90 | $138.17 | 1.84x | $116.73 | $1.0M | 6.3K | 4.8K |
| 2021 | $232.68 | $135.94 | 1.71x | $96.74 | $1.3M | 7.2K | 5.4K |
| 2022 | $326.18 | $174.87 | 1.87x | $151.31 | $1.1M | 6.4K | 4.7K |
| 2023 | $296.84 | $154.07 | 1.93x | $142.77 | $1.1M | 6.0K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 15.4K | $6.2M | $401.06 | 1.78x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 5.4K | $1.5M | $278.42 | 1.85x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 10.1K | $806.7K | $79.55 | 1.58x |
| 66982 | Removal of cataract with insertion of lens | 1.4K | $727.1K | $520.11 | 1.67x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 6.8K | $706.4K | $103.42 | 1.50x |
| 92136 | Measurement of corneal curvature and depth of eye | 17.0K | $698.4K | $41.18 | 2.25x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 3.3K | $405.5K | $122.02 | 1.47x |
| 0191T | Internal insertion of eye fluid drainage device | 510 | $115.3K | $226.11 | 2.68x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.1K | $90.8K | $29.41 | 1.61x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 186 | $85.8K | $461.32 | 2.14x |
| 92083 | Measurement of field of vision during daylight conditions | 1.7K | $75.2K | $43.66 | 1.53x |
| 92134 | Diagnostic imaging of retina | 1.7K | $53.3K | $31.03 | 1.48x |
| 92133 | Diagnostic imaging of optic nerve of eye | 1.8K | $50.2K | $27.70 | 1.53x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 1.7K | $33.1K | $19.61 | 1.53x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 532 | $28.3K | $53.27 | 1.65x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 126 | $25.5K | $202.29 | 1.57x |
| 66183 | Insertion of eye fluid drainage device | 31 | $24.8K | $799.52 | 1.32x |
| 11440 | Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth | 142 | $13.9K | $97.86 | 1.54x |
| 66989 | Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 16 | $9.5K | $592.62 | 1.84x |
| 92100 | Multiple measurements of eye fluid pressure over an extended time period, same day | 139 | $7.9K | $56.59 | 1.44x |
This provider submits charges 1.77 times higher than what Medicare actually pays.
A markup ratio of 1.77x means for every $100 Medicare pays, this provider initially charges $177. 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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