This provider's $7.0M in total Medicare payments ranks in the 97th 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 | $243.22 | $162.32 | 1.50x | $80.90 | $746.0K | 8.8K | 7.0K |
| 2015 | $272.04 | $178.43 | 1.52x | $93.61 | $791.9K | 8.6K | 6.8K |
| 2016 | $338.04 | $211.38 | 1.60x | $126.66 | $869.0K | 8.7K | 6.7K |
| 2017 | $350.86 | $199.91 | 1.76x | $150.95 | $799.0K | 10.4K | 7.8K |
| 2018 | $307.93 | $191.95 | 1.60x | $115.98 | $958.6K | 12.0K | 8.6K |
| 2019 | $252.71 | $154.33 | 1.64x | $98.38 | $1.3M | 15.3K | 9.7K |
| 2020 | $392.57 | $197.81 | 1.98x | $194.76 | $435.4K | 5.0K | 3.6K |
| 2021 | $1.3K | $204.00 | 6.19x | $1.1K | $397.4K | 3.7K | 2.5K |
| 2022 | $1.2K | $177.22 | 6.92x | $1.0K | $335.3K | 3.3K | 2.4K |
| 2023 | $1.2K | $165.82 | 7.06x | $1.0K | $415.2K | 4.2K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 21.7K | $1.7M | $77.65 | 1.91x |
| 66984 | Removal of cataract with insertion of lens | 2.6K | $1.2M | $441.27 | 3.60x |
| J0178 | Injection, aflibercept, 1 mg | 484 | $355.4K | $734.37 | 2.40x |
| 67028 | Injection of drug into eye | 4.4K | $348.9K | $78.56 | 4.19x |
| 92250 | Photography of the retina | 6.0K | $270.2K | $44.72 | 2.46x |
| 92083 | Measurement of field of vision during daylight conditions | 6.0K | $255.7K | $42.44 | 2.57x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 972 | $243.3K | $250.34 | 2.66x |
| 92235 | Examination of retinal blood vessels by ophthalmoscope | 2.5K | $239.0K | $96.25 | 2.26x |
| 66982 | Removal of cataract with insertion of lens | 386 | $225.0K | $582.88 | 2.95x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 1.0K | $221.5K | $218.40 | 3.23x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 2.3K | $195.9K | $84.03 | 3.15x |
| 66180 | Creation of shunt to improve eye fluid flow with graft | 205 | $181.3K | $884.34 | 2.38x |
| 92134 | Diagnostic imaging of retina | 5.7K | $168.3K | $29.37 | 2.47x |
| J7999 | Compounded drug, not otherwise classified | 3.1K | $134.8K | $43.59 | 2.22x |
| 92133 | Diagnostic imaging of optic nerve of eye | 4.7K | $129.4K | $27.46 | 2.41x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 1.5K | $109.5K | $74.10 | 2.72x |
| 92226 | Examination of eye by ophthalmoscope with retinal drawing | 3.4K | $101.6K | $29.91 | 1.67x |
| 67210 | Laser destruction of retinal growth, 1 or more sessions | 241 | $94.0K | $390.24 | 1.44x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 1.5K | $93.0K | $61.16 | 2.03x |
| 0191T | Internal insertion of eye fluid drainage device | 152 | $82.3K | $541.40 | 1.32x |
This provider submits charges 2.61 times higher than what Medicare actually pays.
A markup ratio of 2.61x means for every $100 Medicare pays, this provider initially charges $261. 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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