This provider's $3.8M 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.
Notable: Payments increased 56% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $1.1K | $282.66 | 3.99x | $843.85 | $336.9K | 2.0K | 1.8K |
| 2015 | $1.2K | $247.99 | 4.75x | $928.79 | $401.8K | 2.4K | 2.1K |
| 2016 | $1.3K | $261.34 | 4.88x | $1.0K | $405.8K | 2.5K | 2.2K |
| 2017 | $1.3K | $244.24 | 5.17x | $1.0K | $336.0K | 2.4K | 2.1K |
| 2018 | $1.3K | $267.25 | 4.85x | $1.0K | $367.3K | 2.4K | 2.1K |
| 2019 | $1.4K | $278.97 | 5.09x | $1.1K | $407.8K | 2.4K | 2.1K |
| 2020 | $1.2K | $269.57 | 4.48x | $937.95 | $272.9K | 1.7K | 1.4K |
| 2021 | $820.82 | $268.87 | 3.05x | $551.95 | $426.3K | 2.5K | 2.2K |
| 2022 | $847.32 | $280.18 | 3.02x | $567.14 | $386.1K | 2.3K | 2.0K |
| 2023 | $812.98 | $283.99 | 2.86x | $528.99 | $460.0K | 2.5K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 6.1K | $827.3K | $136.51 | 2.55x |
| 15823 | Removal of excessive skin and fat of upper eyelid | 869 | $644.9K | $742.09 | 4.12x |
| 67908 | Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis | 666 | $304.7K | $457.49 | 6.45x |
| 67904 | Repair of tendon of upper eyelid | 388 | $258.6K | $666.44 | 4.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.0K | $204.1K | $67.14 | 2.25x |
| 67840 | Removal of eyelid growth | 689 | $182.2K | $264.48 | 2.39x |
| 67917 | Extensive repair of turning-outward eyelid defect | 441 | $175.7K | $398.39 | 5.54x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 209 | $152.4K | $729.33 | 2.41x |
| 67971 | Reconstruction of up to two-thirds of the eyelid by transfer of opposite eyelid tissue | 215 | $137.1K | $637.76 | 3.65x |
| 68720 | Creation of drainage tract from tear sac to the nasal cavity | 187 | $128.2K | $685.51 | 4.35x |
| 67924 | Repair of turning-inward eyelid defect | 284 | $123.3K | $434.31 | 5.31x |
| 64612 | Injection of chemical for destruction of nerve muscles on one side of face | 968 | $119.6K | $123.58 | 3.18x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.2K | $110.4K | $93.67 | 2.11x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.8K | $75.5K | $40.98 | 2.49x |
| 68840 | Probing of nasal-tear duct | 463 | $56.9K | $122.87 | 4.16x |
| 92285 | Photography of content of eyes | 2.6K | $53.9K | $20.71 | 2.64x |
| 31239 | Incision of tear duct using an endoscope | 85 | $47.6K | $559.65 | 2.88x |
| 68815 | Probing of nasal-tear duct with insertion of tube or stent | 385 | $47.1K | $122.30 | 8.97x |
| 68810 | Insertion of probe into the tear duct | 148 | $35.2K | $237.92 | 2.35x |
| 92083 | Measurement of field of vision during daylight conditions | 310 | $18.5K | $59.60 | 2.49x |
This provider submits charges 3.72 times higher than what Medicare actually pays.
A markup ratio of 3.72x means for every $100 Medicare pays, this provider initially charges $372. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Nathan Steinle, M.D. | Santa Barbara, CA | $63.1M | ✓ Clear |
| Stephen Couvillion, MD | Santa Barbara, CA | $47.7M | ✓ Clear |
| Margaret Chang, M.D. | Sacramento, CA | $47.6M | ✓ Clear |
| David Boyer, MD | Los Angeles, CA | $47.5M | ✓ Clear |
| Alessandro Castellarin, M.D. | Santa Barbara, CA | $46.9M | ✓ 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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