This provider's $6.2M in total Medicare payments ranks in the 97th 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 | $422.32 | $110.02 | 3.84x | $312.30 | $550.9K | 7.2K | 5.6K |
| 2015 | $481.41 | $147.12 | 3.27x | $334.29 | $499.5K | 6.3K | 4.9K |
| 2016 | $605.39 | $171.92 | 3.52x | $433.47 | $593.1K | 8.0K | 6.2K |
| 2017 | $568.34 | $153.35 | 3.71x | $414.99 | $680.7K | 10.2K | 7.6K |
| 2018 | $535.98 | $135.63 | 3.95x | $400.35 | $668.0K | 9.6K | 7.2K |
| 2019 | $590.97 | $148.09 | 3.99x | $442.88 | $643.2K | 9.4K | 7.1K |
| 2020 | $550.60 | $136.61 | 4.03x | $413.99 | $594.2K | 9.9K | 7.8K |
| 2021 | $542.72 | $132.04 | 4.11x | $410.68 | $733.3K | 11.7K | 9.1K |
| 2022 | $655.37 | $153.60 | 4.27x | $501.77 | $630.9K | 11.5K | 9.2K |
| 2023 | $465.59 | $104.96 | 4.44x | $360.63 | $609.5K | 10.4K | 8.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 13.6K | $783.6K | $57.67 | 1.86x |
| 66984 | Removal of cataract with insertion of lens | 1.6K | $736.1K | $466.17 | 5.26x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 8.4K | $678.1K | $80.57 | 2.00x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.3K | $558.3K | $88.67 | 1.69x |
| 92083 | Measurement of field of vision during daylight conditions | 10.9K | $486.4K | $44.82 | 2.90x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.8K | $355.1K | $192.89 | 8.01x |
| 65778 | Insertion of amniotic membrane to eye surface | 325 | $352.8K | $1.1K | 1.84x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.3K | $330.5K | $249.61 | 4.01x |
| 83861 | Microfluid analysis of tears | 13.4K | $294.4K | $22.02 | 2.27x |
| 92133 | Diagnostic imaging of optic nerve of eye | 10.4K | $281.8K | $27.12 | 4.43x |
| 92134 | Diagnostic imaging of retina | 8.8K | $255.5K | $29.13 | 4.12x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.5K | $222.6K | $64.39 | 1.55x |
| 68761 | Closure of tear duct opening using plug | 1.3K | $170.3K | $134.96 | 4.15x |
| 0191T | Internal insertion of eye fluid drainage device | 277 | $110.3K | $398.23 | 7.53x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 811 | $85.6K | $105.60 | 2.08x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.9K | $78.0K | $41.08 | 4.87x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 322 | $71.7K | $222.69 | 5.41x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 3.6K | $70.4K | $19.46 | 2.57x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 352 | $50.0K | $142.13 | 1.91x |
| 92250 | Photography of the retina | 1.3K | $46.9K | $37.12 | 3.72x |
This provider submits charges 3.37 times higher than what Medicare actually pays.
A markup ratio of 3.37x means for every $100 Medicare pays, this provider initially charges $337. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Timothy Byrnes, MD | Roanoke, VA | $53.3M | ✓ Clear |
| James Tiedeman | Fishersville, VA | $51.1M | ✓ Clear |
| Juan Astruc, M.D. | Richmond, VA | $46.6M | ✓ Clear |
| Kapil Kapoor, MD | Norfolk, VA | $43.0M | ✓ Clear |
| Alan Wagner, MD | Norfolk, VA | $42.8M | ✓ 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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