This provider's $6.9M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Their average markup ratio of 5.61x is significantly above the specialty median of 2.9x.
62% 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 | $542.32 | $146.15 | 3.71x | $396.17 | $738.8K | 3.4K | 2.4K |
| 2015 | $736.37 | $187.88 | 3.92x | $548.49 | $706.4K | 3.1K | 2.1K |
| 2016 | $752.24 | $187.63 | 4.01x | $564.61 | $638.5K | 2.8K | 1.9K |
| 2017 | $742.23 | $181.52 | 4.09x | $560.71 | $592.4K | 2.6K | 1.8K |
| 2018 | $679.00 | $169.68 | 4.00x | $509.32 | $760.8K | 3.2K | 2.2K |
| 2019 | $931.48 | $211.26 | 4.41x | $720.22 | $735.7K | 3.0K | 1.9K |
| 2020 | $996.58 | $216.60 | 4.60x | $779.98 | $700.8K | 3.1K | 2.0K |
| 2021 | $1.2K | $224.86 | 5.34x | $976.24 | $684.0K | 3.1K | 2.0K |
| 2022 | $1.3K | $230.03 | 5.45x | $1.0K | $683.9K | 3.4K | 2.2K |
| 2023 | $1.2K | $216.33 | 5.58x | $991.69 | $668.1K | 3.4K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 9.9K | $4.3M | $434.77 | 6.38x |
| 66982 | Removal of cataract with insertion of lens | 1.3K | $726.9K | $566.12 | 5.30x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.5K | $565.0K | $228.75 | 3.72x |
| 92136 | Measurement of corneal curvature and depth of eye | 11.3K | $427.8K | $37.93 | 4.96x |
| 0191T | Internal insertion of eye fluid drainage device | 454 | $227.7K | $501.65 | 4.58x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $207.9K | $111.38 | 1.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.4K | $103.2K | $75.58 | 1.52x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 122 | $73.6K | $603.24 | 2.94x |
| 65820 | Incision to improve eye fluid flow | 93 | $54.6K | $586.72 | 2.95x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 136 | $53.1K | $390.45 | 9.67x |
| 0376T | Insertion of eye drainage device | 178 | $44.5K | $249.85 | 9.21x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 237 | $39.9K | $168.50 | 8.31x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 353 | $28.9K | $81.74 | 1.53x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 214 | $13.4K | $62.52 | 1.36x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 228 | $11.9K | $52.28 | 1.60x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 100 | $10.1K | $101.45 | 1.48x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 124 | $9.1K | $73.36 | 1.66x |
| 67840 | Removal of eyelid growth | 38 | $8.2K | $216.48 | 2.29x |
| 92082 | Measurement of field of vision during daylight conditions | 218 | $7.4K | $33.96 | 2.80x |
| 92134 | Diagnostic imaging of retina | 155 | $4.4K | $28.12 | 3.28x |
This provider submits charges 5.61 times higher than what Medicare actually pays.
A markup ratio of 5.61x means for every $100 Medicare pays, this provider initially charges $561. 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 IN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Drew Sommerville, MD | Evansville, IN | $35.4M | ✓ 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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