This provider's $5.4M in total Medicare payments ranks in the 96th percentile of Ophthalmology providers nationally.
Their average markup ratio of 5.46x is significantly above the specialty median of 2.9x.
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 | $1.4K | $260.84 | 5.45x | $1.2K | $751.9K | 3.5K | 2.4K |
| 2015 | $1.3K | $254.70 | 4.96x | $1.0K | $777.2K | 3.7K | 2.6K |
| 2016 | $1.2K | $250.53 | 4.99x | $998.75 | $731.0K | 3.4K | 2.4K |
| 2017 | $1.1K | $221.19 | 5.03x | $892.28 | $657.2K | 2.8K | 1.8K |
| 2018 | $1.1K | $226.74 | 4.84x | $870.06 | $540.8K | 2.3K | 1.5K |
| 2019 | $1.3K | $250.23 | 5.22x | $1.1K | $522.0K | 2.3K | 1.5K |
| 2020 | $1.4K | $250.31 | 5.54x | $1.1K | $397.7K | 1.9K | 1.2K |
| 2021 | $1.5K | $266.35 | 5.68x | $1.2K | $379.9K | 1.8K | 1.1K |
| 2022 | $1.4K | $232.21 | 6.07x | $1.2K | $303.4K | 1.5K | 952 |
| 2023 | $964.73 | $179.35 | 5.38x | $785.38 | $365.1K | 1.9K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of lens | 6.6K | $2.7M | $410.11 | 6.77x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 5.6K | $1.2M | $213.56 | 3.98x |
| 66982 | Removal of cataract with insertion of lens | 943 | $506.7K | $537.38 | 5.58x |
| 92136 | Measurement of corneal curvature and depth of eye | 7.6K | $319.2K | $41.89 | 3.52x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.3K | $257.9K | $110.95 | 1.52x |
| 0191T | Internal insertion of eye fluid drainage device | 195 | $98.8K | $506.83 | 4.54x |
| 66711 | Destruction of tissue encircling lens using en endoscope | 251 | $93.8K | $373.73 | 4.44x |
| 67031 | Laser release of scar tissue between the lens and retina | 348 | $86.9K | $249.60 | 3.52x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 467 | $75.9K | $162.63 | 8.60x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 339 | $26.0K | $76.79 | 1.55x |
| 66988 | Removal of cataract with insertion of lens and laser treatment to decrease fluid production in eye | 42 | $20.9K | $497.50 | 7.01x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 117 | $19.5K | $166.52 | 4.56x |
| 0376T | Insertion of eye drainage device | 46 | $11.4K | $247.21 | 9.37x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 123 | $7.6K | $61.64 | 1.38x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 57 | $3.8K | $65.99 | 1.54x |
| 92083 | Measurement of field of vision during daylight conditions | 25 | $1.1K | $43.41 | 2.76x |
| 92134 | Imaging of retina | 13 | $371.41 | $28.57 | 2.07x |
This provider submits charges 5.46 times higher than what Medicare actually pays.
A markup ratio of 5.46x means for every $100 Medicare pays, this provider initially charges $546. 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 IN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Drew Sommerville, MD | Evansville, IN | $35.4M | ✓ 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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