This provider's $5.3M in total Medicare payments ranks in the 96th 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 | $286.72 | $182.32 | 1.57x | $104.40 | $537.1K | 5.9K | 4.9K |
| 2015 | $259.45 | $187.68 | 1.38x | $71.77 | $556.9K | 5.8K | 4.8K |
| 2016 | $179.96 | $129.31 | 1.39x | $50.65 | $566.6K | 5.7K | 4.7K |
| 2017 | $180.12 | $128.38 | 1.40x | $51.74 | $604.3K | 6.2K | 5.1K |
| 2018 | $230.09 | $163.39 | 1.41x | $66.70 | $576.4K | 6.2K | 5.1K |
| 2019 | $196.90 | $142.79 | 1.38x | $54.11 | $611.1K | 6.3K | 5.0K |
| 2020 | $161.91 | $115.81 | 1.40x | $46.10 | $359.9K | 4.4K | 3.7K |
| 2021 | $198.21 | $146.06 | 1.36x | $52.15 | $492.0K | 5.6K | 4.8K |
| 2022 | $173.37 | $117.73 | 1.47x | $55.64 | $457.1K | 5.4K | 4.5K |
| 2023 | $270.97 | $127.90 | 2.12x | $143.07 | $553.8K | 5.2K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 12.1K | $1.8M | $145.91 | 1.57x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 7.2K | $711.9K | $98.93 | 1.54x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 7.9K | $459.1K | $58.46 | 1.51x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 1.7K | $457.8K | $273.16 | 1.45x |
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 4.0K | $321.3K | $81.30 | 1.57x |
| 92136 | Measurement of corneal curvature and depth of eye | 7.7K | $305.1K | $39.88 | 1.95x |
| 66982 | Removal of cataract with insertion of lens | 1.0K | $257.2K | $247.56 | 1.58x |
| 65820 | Incision to improve eye fluid flow | 284 | $173.5K | $610.86 | 1.39x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 880 | $173.0K | $196.64 | 1.44x |
| 0191T | Internal insertion of eye fluid drainage device | 198 | $153.1K | $773.21 | 1.41x |
| 92083 | Measurement of field of vision during daylight conditions | 3.2K | $146.3K | $45.62 | 1.47x |
| 92133 | Diagnostic imaging of optic nerve of eye | 3.7K | $95.7K | $26.14 | 1.70x |
| 92002 | Eye and medical examination for diagnosis and treatment, new patient | 1.5K | $79.5K | $52.18 | 1.64x |
| 66170 | Creation of eye fluid drainage tract | 64 | $56.0K | $874.59 | 1.37x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 2.1K | $41.4K | $19.35 | 1.46x |
| 92250 | Photography of the retina | 909 | $37.7K | $41.49 | 1.55x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 114 | $25.4K | $222.72 | 1.39x |
| 66250 | Revision or repair of operative wound of eye | 44 | $23.8K | $541.15 | 1.41x |
| 76514 | Ultrasound of corneal structure and measurement | 1.9K | $17.0K | $9.16 | 1.59x |
| 92134 | Diagnostic imaging of retina | 206 | $6.1K | $29.63 | 1.54x |
This provider submits charges 1.56 times higher than what Medicare actually pays.
A markup ratio of 1.56x means for every $100 Medicare pays, this provider initially charges $156. This is lower 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Timothy Byrnes, MD | Roanoke, VA | $53.3M | ✓ Clear |
| James Tiedeman | Fishersville, VA | $51.1M | ✓ Clear |
| Juan Astruc, M.D. | Richmond, VA | $46.6M | ✓ Clear |
| Kapil Kapoor, MD | Norfolk, VA | $43.0M | ✓ Clear |
| Alan Wagner, MD | Norfolk, VA | $42.8M | ✓ 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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