This provider averages 64 services per working day
Based on 158.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $17.9M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.
Averaging 64 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 406% 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 | $267.21 | $127.35 | 2.10x | $139.86 | $630.4K | 5.0K | 13 |
| 2015 | $265.10 | $128.44 | 2.06x | $136.66 | $863.4K | 6.7K | 17 |
| 2016 | $182.44 | $79.26 | 2.30x | $103.18 | $943.8K | 11.9K | 22 |
| 2017 | $223.04 | $99.69 | 2.24x | $123.35 | $1.3M | 12.6K | 23 |
| 2018 | $259.75 | $122.52 | 2.12x | $137.23 | $1.6M | 12.8K | 24 |
| 2019 | $280.16 | $136.24 | 2.06x | $143.92 | $1.9M | 14.0K | 21 |
| 2020 | $343.86 | $167.53 | 2.05x | $176.33 | $2.6M | 15.3K | 18 |
| 2021 | $345.79 | $164.85 | 2.10x | $180.94 | $2.5M | 15.1K | 18 |
| 2022 | $315.20 | $139.15 | 2.27x | $176.05 | $2.5M | 17.8K | 19 |
| 2023 | $163.58 | $66.82 | 2.45x | $96.76 | $3.2M | 47.7K | 22 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 8.3K | $6.1M | $735.31 | 1.66x |
| J2778 | Injection, ranibizumab, 0.1 mg | 14.7K | $3.6M | $244.93 | 2.01x |
| 67028 | Injection of drug into eye | 18.6K | $1.6M | $88.49 | 4.47x |
| 92014 | Established patient complete exam of visual system | 13.3K | $1.1M | $85.86 | 1.69x |
| 92134 | Imaging of retina | 32.6K | $974.0K | $29.86 | 2.18x |
| J2777 | Injection, faricimab-svoa, 0.1 mg | 32.2K | $938.3K | $29.12 | 2.46x |
| J9035 | Injection, bevacizumab, 10 mg | 15.5K | $870.7K | $56.26 | 1.80x |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 2.7K | $418.2K | $156.81 | 1.50x |
| 92004 | New patient complete exam of visual system | 3.1K | $303.4K | $97.73 | 1.93x |
| 67042 | Removal of membrane of retina with removal of internal limiting membrane of retina | 296 | $263.0K | $888.52 | 2.19x |
| 66984 | Removal of cataract with insertion of prosthetic lens | 664 | $233.2K | $351.25 | 3.56x |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1.5K | $182.3K | $120.36 | 2.44x |
| 67108 | Repair of detached retina with drainage and removal of eye fluid between lens and retina | 169 | $166.3K | $984.26 | 3.15x |
| 67036 | Removal of eye fluid (vitreous) between lens and retina | 212 | $146.1K | $689.34 | 2.25x |
| 92235 | Exam of retinal blood vessels using a special camera after injection of a dye | 1.8K | $135.5K | $75.05 | 2.32x |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 444 | $111.5K | $251.21 | 4.12x |
| J3490 | Unclassified drugs | 64 | $108.0K | $1.7K | 2.54x |
| 67040 | Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser | 118 | $92.9K | $786.88 | 3.81x |
| 92250 | Photography of the retina | 2.1K | $85.1K | $40.64 | 2.83x |
| 67228 | Laser destruction of leaking retinal blood vessels, 1 or more sessions | 188 | $79.7K | $423.92 | 3.30x |
This provider submits charges 2.19 times higher than what Medicare actually pays.
A markup ratio of 2.19x means for every $100 Medicare pays, this provider initially charges $219. 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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