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Market snapshot

67516 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

67516 — Injection of drug into the space between the cornea and retina in the eye

Billing groups
14
Named-group FFS services
631
FFS of Medicare
49%
Services YoY
Estimated all-Medicare volume FFS + estimated MA estimate
~1,239 services

631 observed fee-for-service (51%) · ~608 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Top states — 67516 (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$410K
Named-group allowed amount
$77K
Named-group Medicare payments
$60K
Avg charge / svc
$649
Avg allowed / svc
$122
Avg payment / svc
$95
Average charge per group
$135 14 groups · avg submitted charge / service $1,500
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 67516 services, CY2024
#Physician group City St Specialty Providers 67516 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 TEXAS RETINA ASSOCIATES DALLAS TX OPHTHALMOLOGY 18 196 $178,200 $909 premium 69.3% (214) 692-6941
2 KOVACH EYE INSTITUTE LTD ELMHURST IL OPHTHALMOLOGY 6 62 $18,600 $300 premium 100.0% (630) 833-9621
3 CUMBERLAND VALLEY RETINA CONSULTANTS PC HAGERSTOWN MD OPHTHALMOLOGY 5 62 $62,000 $1,000 premium 100.0% 30166517121027
4 RETINAL CONSULTANTS OF ARIZONA LTD PHOENIX AZ OPHTHALMOLOGY 8 47 $13,920 $296 premium 39.2% (800) 640-6442
5 JAWAD A QURESHI MD PA SOUTHLAKE TX OPHTHALMOLOGY 7 40 $12,600 $315 premium 14.1% (817) 865-6800
6 RETINA ASSOCIATES OF CLEVELAND, INC. BEACHWOOD OH OPHTHALMOLOGY 19 30 $6,882 $229 premium 100.0%
7 WOLFE CLINIC INC MARSHALLTOWN IA OPHTHALMOLOGY 36 29 $17,400 $600 premium 100.0% (641) 754-6200
8 PANHANDLE EYE GROUP, LLP AMARILLO TX OPHTHALMOLOGY 11 29 $10,150 $350 premium 10.2% (806) 351-1870
9 MARK FLECKNER M.D., P.C. GARDEN CITY NY OPHTHALMOLOGY 2 28 $42,000 $1,500 premium 100.0% (516) 739-5905
10 RETINOVITREOUS ASSOCIATES LTD PHILADELPHIA PA OPHTHALMOLOGY 39 27 $10,800 $400 premium 25.2% (800) 331-6634
11 MANATEE SARASOTA EYE CLINIC PA BRADENTON FL OPHTHALMOLOGY 10 26 $3,510 $135 premium 100.0% (941) 748-1818
12 RETINA CONSULTANTS LLC BRENTWOOD MO OPHTHALMOLOGY 18 20 $4,567 $228 premium 55.6% (314) 367-1181
13 OPHTHALMIC CONSULTANTS OF BOSTON INC BOSTON MA OPHTHALMOLOGY 70 19 $19,000 $1,000 premium 54.3% (617) 367-4800
14 MASSACHUSETTS EYE RESEARCH AND SURGERY INSTITUTION PC WALTHAM MA OPHTHALMOLOGY 5 16 $10,200 $638 premium 45.7%

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →