This provider averages 53 services per working day
Based on 131.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $10.5M in total Medicare payments ranks in the 98th percentile of Ophthalmology providers nationally.
Averaging 53 services per working day raises questions about billing patterns.
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 | $464.65 | $203.45 | 2.28x | $261.20 | $803.8K | 9.9K | 4.6K |
| 2015 | $469.99 | $181.53 | 2.59x | $288.46 | $1.0M | 12.4K | 5.4K |
| 2016 | $700.92 | $231.71 | 3.02x | $469.21 | $1.2M | 14.1K | 6.4K |
| 2017 | $608.48 | $202.96 | 3.00x | $405.52 | $1.3M | 16.6K | 7.9K |
| 2018 | $663.05 | $193.98 | 3.42x | $469.07 | $1.1M | 14.1K | 6.6K |
| 2019 | $630.42 | $211.12 | 2.99x | $419.30 | $1.2M | 14.8K | 6.6K |
| 2020 | $425.57 | $147.89 | 2.88x | $277.68 | $911.8K | 11.6K | 5.4K |
| 2021 | $480.15 | $152.32 | 3.15x | $327.83 | $1.1M | 13.1K | 6.3K |
| 2022 | $451.94 | $136.88 | 3.30x | $315.06 | $993.0K | 12.7K | 5.7K |
| 2023 | $572.60 | $165.04 | 3.47x | $407.56 | $922.7K | 12.0K | 5.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 26.1K | $2.4M | $93.80 | 2.11x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 10.4K | $888.1K | $85.43 | 3.25x |
| J0178 | Injection, aflibercept, 1 mg | 1.1K | $782.0K | $723.41 | 1.99x |
| 92134 | Diagnostic imaging of retina | 23.6K | $763.6K | $32.39 | 2.88x |
| 67028 | Injection of drug into eye | 7.8K | $660.0K | $84.52 | 4.11x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 1.4K | $595.4K | $419.90 | 3.83x |
| 92250 | Photography of the retina | 13.0K | $590.0K | $45.25 | 2.96x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.9K | $392.8K | $212.35 | 2.51x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 944 | $378.2K | $400.65 | 5.30x |
| J7999 | Compounded drug, not otherwise classified | 5.0K | $314.1K | $62.39 | 4.93x |
| 92240 | Examination of eye using an endoscope | 1.6K | $301.5K | $193.03 | 2.16x |
| 92273 | Full field recording of retinal electrical responses to external stimuli with interpretation and report | 2.4K | $269.7K | $113.32 | 3.13x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 3.9K | $265.7K | $68.70 | 2.01x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $210.5K | $111.47 | 2.12x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 8.9K | $181.6K | $20.32 | 2.60x |
| 67042 | Removal of membrane from the retina, pars plana approach | 145 | $148.5K | $1.0K | 2.66x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 515 | $142.7K | $277.05 | 2.18x |
| 92083 | Measurement of field of vision during daylight conditions | 2.1K | $107.0K | $51.80 | 2.87x |
| 67040 | Laser destruction of eye fluid (vitreous) between the lens and retina | 108 | $83.7K | $775.17 | 3.35x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 113 | $75.8K | $670.70 | 3.05x |
This provider submits charges 2.91 times higher than what Medicare actually pays.
A markup ratio of 2.91x means for every $100 Medicare pays, this provider initially charges $291. 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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