This provider's $5.3M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Medicare payments to this provider grew 54% from 2014 to 2023.
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 | $969.56 | $347.30 | 2.79x | $622.26 | $530.0K | 4.7K | 1.9K |
| 2015 | $810.89 | $245.81 | 3.30x | $565.08 | $500.5K | 4.8K | 1.9K |
| 2016 | $408.65 | $149.48 | 2.73x | $259.17 | $379.6K | 3.6K | 1.5K |
| 2017 | $532.53 | $190.17 | 2.80x | $342.36 | $389.3K | 3.9K | 1.6K |
| 2018 | $734.68 | $233.85 | 3.14x | $500.83 | $460.6K | 4.1K | 1.7K |
| 2019 | $412.60 | $146.91 | 2.81x | $265.69 | $510.0K | 4.7K | 1.9K |
| 2020 | $764.91 | $235.55 | 3.25x | $529.36 | $593.2K | 5.0K | 1.8K |
| 2021 | $725.19 | $232.90 | 3.11x | $492.29 | $556.9K | 4.8K | 1.6K |
| 2022 | $798.42 | $268.98 | 2.97x | $529.44 | $568.7K | 5.0K | 1.8K |
| 2023 | $450.91 | $210.13 | 2.15x | $240.78 | $816.3K | 6.0K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 5.0K | $1.4M | $274.61 | 1.82x |
| 67028 | Injection of drug into eye | 10.6K | $894.9K | $84.72 | 3.66x |
| J0178 | Injection, aflibercept, 1 mg | 994 | $710.6K | $714.86 | 1.79x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 5.0K | $412.2K | $82.52 | 2.83x |
| 92134 | Diagnostic imaging of retina | 13.1K | $380.2K | $29.11 | 3.05x |
| J3490 | Unclassified drugs | 182 | $315.8K | $1.7K | 1.57x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.1K | $161.5K | $75.80 | 2.81x |
| J9035 | Injection, bevacizumab, 10 mg | 2.3K | $123.3K | $54.19 | 2.08x |
| 67036 | Removal of eye fluid (vitreous) between the lens and retina | 129 | $86.3K | $668.67 | 2.69x |
| J7999 | Compounded drug, not otherwise classified | 1.3K | $84.2K | $65.77 | 6.39x |
| 92250 | Photography of the retina | 2.3K | $80.4K | $35.14 | 4.15x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 665 | $76.7K | $115.40 | 2.75x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 179 | $70.6K | $394.16 | 4.87x |
| 67042 | Removal of membrane from the retina, pars plana approach | 68 | $63.3K | $931.19 | 3.62x |
| 92240 | Examination of eye using an endoscope | 328 | $57.0K | $173.78 | 2.59x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 71 | $55.7K | $784.66 | 2.60x |
| 67039 | Laser destruction of eye fluid (vitreous) between the lens and retina | 71 | $55.5K | $781.90 | 4.08x |
| J3590 | Unclassified biologics | 47 | $51.3K | $1.1K | 2.24x |
| 67041 | Removal of membrane from the retina | 50 | $47.4K | $948.34 | 3.31x |
| 92242 | Imaging of blood vessels in back of eye using fluorescein and indocyanine-green dye | 236 | $40.2K | $170.28 | 2.53x |
This provider submits charges 2.59 times higher than what Medicare actually pays.
A markup ratio of 2.59x means for every $100 Medicare pays, this provider initially charges $259. 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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