This provider's $7.9M in total Medicare payments ranks in the 98th 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 | $431.58 | $208.01 | 2.07x | $223.57 | $818.3K | 9.7K | 7.1K |
| 2015 | $328.98 | $232.15 | 1.42x | $96.83 | $867.0K | 9.9K | 7.5K |
| 2016 | $277.36 | $203.86 | 1.36x | $73.50 | $999.7K | 10.7K | 8.1K |
| 2017 | $298.87 | $222.40 | 1.34x | $76.47 | $893.7K | 10.1K | 7.4K |
| 2018 | $328.64 | $234.03 | 1.40x | $94.61 | $767.9K | 9.4K | 6.7K |
| 2019 | $316.59 | $237.37 | 1.33x | $79.22 | $774.6K | 9.6K | 6.7K |
| 2020 | $308.77 | $191.80 | 1.61x | $116.97 | $628.9K | 8.4K | 5.8K |
| 2021 | $265.06 | $199.44 | 1.33x | $65.62 | $733.8K | 9.3K | 6.2K |
| 2022 | $292.70 | $210.46 | 1.39x | $82.24 | $729.5K | 9.9K | 6.3K |
| 2023 | $295.87 | $204.95 | 1.44x | $90.92 | $683.7K | 9.9K | 6.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 24.1K | $1.9M | $80.17 | 1.61x |
| 92083 | Measurement of field of vision during daylight conditions | 25.8K | $1.2M | $46.57 | 1.52x |
| 66984 | Removal of cataract with insertion of lens | 1.7K | $703.2K | $417.33 | 1.44x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 7.8K | $685.5K | $87.96 | 1.51x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 2.1K | $430.9K | $204.43 | 1.48x |
| 66183 | Insertion of eye fluid drainage device | 532 | $427.9K | $804.41 | 1.37x |
| 92133 | Diagnostic imaging of optic nerve of eye | 15.8K | $401.3K | $25.36 | 1.78x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.0K | $310.6K | $61.65 | 1.45x |
| 0191T | Internal insertion of eye fluid drainage device | 546 | $306.1K | $560.54 | 1.37x |
| 66250 | Revision or repair of operative wound of eye | 435 | $191.4K | $439.98 | 1.52x |
| 66180 | Creation of shunt to improve eye fluid flow | 213 | $189.8K | $890.95 | 1.34x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 440 | $188.0K | $427.22 | 1.38x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 663 | $162.9K | $245.71 | 1.33x |
| 92136 | Measurement of corneal curvature and depth of eye | 1.8K | $91.0K | $49.68 | 1.62x |
| 65820 | Incision to improve eye fluid flow | 135 | $84.7K | $627.69 | 1.29x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 776 | $78.6K | $101.31 | 1.53x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 581 | $66.3K | $114.12 | 1.50x |
| 0449T | Insertion of aqueous fluid drainage device into eye | 110 | $64.0K | $582.22 | 1.37x |
| 92250 | Photography of the retina | 1.4K | $62.2K | $43.92 | 1.56x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 2.5K | $49.6K | $20.14 | 1.62x |
This provider submits charges 1.52 times higher than what Medicare actually pays.
A markup ratio of 1.52x means for every $100 Medicare pays, this provider initially charges $152. 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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