This provider's $6.5M in total Medicare payments ranks in the 97th percentile of Ophthalmology providers nationally.
Their average markup ratio of 5.52x is significantly above the specialty median of 2.9x.
Medicare payments to this provider grew 121% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% 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 | $608.57 | $119.61 | 5.09x | $488.96 | $398.0K | 5.6K | 4.9K |
| 2015 | $473.13 | $92.98 | 5.09x | $380.15 | $438.2K | 6.7K | 5.8K |
| 2016 | $561.24 | $107.27 | 5.23x | $453.97 | $511.4K | 7.9K | 6.9K |
| 2017 | $953.10 | $150.31 | 6.34x | $802.79 | $662.5K | 8.7K | 7.9K |
| 2018 | $1.2K | $147.46 | 7.89x | $1.0K | $686.9K | 9.2K | 8.2K |
| 2019 | $1.1K | $165.97 | 6.41x | $898.53 | $697.8K | 9.3K | 8.2K |
| 2020 | $1.1K | $163.64 | 6.53x | $904.64 | $558.5K | 7.1K | 6.2K |
| 2021 | $1.2K | $189.02 | 6.37x | $1.0K | $864.2K | 9.1K | 7.9K |
| 2022 | $1.2K | $202.66 | 5.84x | $981.03 | $789.6K | 9.3K | 8.3K |
| 2023 | $1.0K | $169.16 | 5.92x | $831.70 | $879.1K | 10.2K | 9.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 21.2K | $1.9M | $89.45 | 4.31x |
| 66984 | Removal of cataract with insertion of lens | 3.3K | $877.2K | $264.44 | 6.90x |
| 92083 | Measurement of field of vision during daylight conditions | 11.4K | $533.1K | $46.66 | 6.21x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 7.4K | $492.5K | $66.59 | 4.13x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.4K | $478.8K | $57.07 | 3.85x |
| 92133 | Diagnostic imaging of optic nerve of eye | 13.9K | $400.3K | $28.87 | 5.58x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.6K | $296.4K | $181.05 | 8.52x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.0K | $258.2K | $254.85 | 4.30x |
| 92136 | Measurement of corneal curvature and depth of eye | 4.0K | $173.0K | $43.34 | 6.76x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.6K | $167.4K | $103.77 | 4.18x |
| 0191T | Internal insertion of eye fluid drainage device | 358 | $103.5K | $289.24 | 19.85x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 870 | $98.6K | $113.38 | 4.79x |
| 66183 | Insertion of eye fluid drainage device | 109 | $93.2K | $854.95 | 3.74x |
| 66991 | Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye | 194 | $91.8K | $472.98 | 12.10x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 428 | $87.1K | $203.60 | 7.13x |
| 66982 | Removal of cataract with insertion of lens | 234 | $79.6K | $340.04 | 5.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 878 | $71.4K | $81.31 | 3.28x |
| 65820 | Incision to improve eye fluid flow | 102 | $67.1K | $657.54 | 3.38x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 2.3K | $50.2K | $21.55 | 3.94x |
| 66710 | Destruction of lens tissue using laser | 122 | $39.1K | $320.30 | 4.35x |
This provider submits charges 5.52 times higher than what Medicare actually pays.
A markup ratio of 5.52x means for every $100 Medicare pays, this provider initially charges $552. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Torsten Wiegand, MD | Boston, MA | $49.8M | ✓ Clear |
| David Reed, M.D. | Plymouth, MA | $44.2M | ✓ Clear |
| Chirag Shah, MD | Boston, MA | $34.3M | ✓ 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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