This provider's $8.5M 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 | $677.43 | $173.90 | 3.90x | $503.53 | $882.1K | 10.4K | 8.3K |
| 2015 | $655.24 | $173.26 | 3.78x | $481.98 | $755.8K | 9.5K | 7.9K |
| 2016 | $561.62 | $197.92 | 2.84x | $363.70 | $982.6K | 11.1K | 8.3K |
| 2017 | $614.66 | $215.21 | 2.86x | $399.45 | $904.7K | 11.1K | 8.2K |
| 2018 | $599.79 | $208.50 | 2.88x | $391.29 | $845.0K | 10.7K | 8.1K |
| 2019 | $649.85 | $228.26 | 2.85x | $421.59 | $941.3K | 12.0K | 9.0K |
| 2020 | $695.60 | $230.74 | 3.01x | $464.86 | $874.3K | 10.8K | 8.2K |
| 2021 | $547.45 | $170.44 | 3.21x | $377.01 | $878.7K | 11.4K | 8.5K |
| 2022 | $523.73 | $174.80 | 3.00x | $348.93 | $742.0K | 10.7K | 8.2K |
| 2023 | $519.89 | $169.09 | 3.07x | $350.80 | $715.4K | 11.0K | 8.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 13.1K | $1.1M | $80.41 | 1.62x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 17.8K | $1.0M | $58.29 | 1.59x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 4.1K | $782.8K | $191.48 | 5.18x |
| 92083 | Measurement of field of vision during daylight conditions | 18.8K | $781.7K | $41.62 | 2.87x |
| 66984 | Removal of cataract with insertion of lens | 2.3K | $758.7K | $324.08 | 6.00x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 2.1K | $498.0K | $238.37 | 3.96x |
| 66170 | Creation of eye fluid drainage tract | 590 | $478.4K | $810.84 | 2.01x |
| 92133 | Diagnostic imaging of optic nerve of eye | 12.6K | $325.6K | $25.83 | 3.04x |
| 66180 | Creation of shunt to improve eye fluid flow | 330 | $279.0K | $845.58 | 2.12x |
| 65820 | Incision to improve eye fluid flow | 398 | $239.5K | $601.85 | 3.30x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 1.1K | $231.2K | $209.39 | 3.95x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 2.3K | $221.2K | $95.82 | 1.57x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.2K | $208.4K | $65.81 | 2.08x |
| 92250 | Photography of the retina | 5.5K | $196.7K | $35.87 | 2.58x |
| 66982 | Removal of cataract with insertion of lens | 424 | $187.4K | $442.06 | 5.43x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 401 | $180.0K | $448.79 | 1.84x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 9.0K | $167.5K | $18.53 | 2.55x |
| 92136 | Measurement of corneal curvature and depth of eye | 2.8K | $108.4K | $38.49 | 3.28x |
| 66174 | Dilation to improve eye fluid flow | 146 | $101.7K | $696.43 | 2.28x |
| 66172 | Creation of eye fluid drainage tract | 91 | $80.3K | $882.58 | 2.04x |
This provider submits charges 3.05 times higher than what Medicare actually pays.
A markup ratio of 3.05x means for every $100 Medicare pays, this provider initially charges $305. 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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