This provider's $3.7M in total Medicare payments ranks in the 95th 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 | $515.18 | $259.47 | 1.99x | $255.71 | $411.8K | 3.1K | 2.6K |
| 2015 | $456.06 | $224.13 | 2.03x | $231.93 | $488.8K | 4.3K | 3.5K |
| 2016 | $509.50 | $243.65 | 2.09x | $265.85 | $404.0K | 3.4K | 3.0K |
| 2017 | $579.42 | $277.33 | 2.09x | $302.09 | $395.3K | 2.9K | 2.6K |
| 2018 | $594.48 | $249.58 | 2.38x | $344.90 | $371.9K | 2.9K | 2.6K |
| 2019 | $629.82 | $252.17 | 2.50x | $377.65 | $353.7K | 2.6K | 2.4K |
| 2020 | $635.86 | $233.68 | 2.72x | $402.18 | $288.4K | 2.2K | 2.0K |
| 2021 | $531.38 | $240.99 | 2.20x | $290.39 | $320.6K | 2.3K | 2.1K |
| 2022 | $562.33 | $243.78 | 2.31x | $318.55 | $362.0K | 2.7K | 2.4K |
| 2023 | $555.45 | $265.99 | 2.09x | $289.46 | $342.6K | 2.5K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 67904 | Repair of tendon of upper eyelid | 1.6K | $945.3K | $597.56 | 2.17x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 4.6K | $326.2K | $70.34 | 1.54x |
| 67917 | Extensive repair of turning-outward eyelid defect | 947 | $282.0K | $297.80 | 2.62x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 532 | $239.4K | $450.00 | 1.79x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.4K | $221.4K | $50.37 | 1.54x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 354 | $206.8K | $584.12 | 2.89x |
| 67966 | Removal of over one-fourth of the eyelid involving lid margin | 324 | $147.8K | $456.30 | 1.90x |
| 67924 | Repair of turning-inward eyelid defect | 420 | $136.0K | $323.91 | 2.26x |
| 68840 | Probing of nasal-tear duct | 1.2K | $130.7K | $105.35 | 1.81x |
| 67412 | Removal of growth in cavity behind eye | 168 | $115.2K | $685.46 | 1.57x |
| 68815 | Probing of nasal-tear duct with insertion of tube or stent | 903 | $97.0K | $107.47 | 5.29x |
| 15732 | Muscle flap wound repair at head and neck | 105 | $88.2K | $840.41 | 1.56x |
| 68720 | Creation of drainage tract from tear sac to the nasal cavity | 156 | $87.9K | $563.17 | 1.50x |
| 64612 | Injection of chemical for destruction of nerve muscles on one side of face | 688 | $78.8K | $114.56 | 1.87x |
| 92285 | Photography of content of eyes | 5.6K | $75.9K | $13.43 | 1.80x |
| 67900 | Repair of brow paralysis | 268 | $75.8K | $282.94 | 4.28x |
| 67961 | Removal of up to one-fourth of the eyelid involving lid margin | 234 | $75.5K | $322.53 | 2.05x |
| 67840 | Removal of eyelid growth | 627 | $73.8K | $117.71 | 2.57x |
| 92082 | Measurement of field of vision during daylight conditions | 2.2K | $68.8K | $30.93 | 1.65x |
| 68700 | Plastic repair of tear ducts | 135 | $47.0K | $348.30 | 2.14x |
This provider submits charges 2.16 times higher than what Medicare actually pays.
A markup ratio of 2.16x means for every $100 Medicare pays, this provider initially charges $216. 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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