Ophthalmology · Louisiana

Ophthalmology commercial reimbursement in Louisiana

How Louisiana ophthalmology rates compare with the national market.

Ophthalmology in Louisiana

42 codes · 110 sampled providers
Index vs national
88
12% below
Rank among states
39 of 50
1 = highest
Codes above national
0 of 42
median code at 88%
Providers
110
sampled

What the data shows

1

Ophthalmology ranks 39th of 50 states in Louisiana with an index of 88 (100 = the specialty's national median), across 42 codes and 110 sampled providers.

2

Of the 42 ophthalmology codes with enough data in Louisiana, 0 pay above the national median and 42 below; the typical code sits at 88% of the national median.

3

Largest premium over the national median: CPT 66821 (After cataract laser surgery) at 98%; largest discount: CPT 76512 (Oph us dx b-scan) at 82%.

4

Measured against Medicare, Louisiana ophthalmology rates have a median of 112% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeLouisianaNationalGapProv.
66821
After cataract laser surgery
$386$393-2%109
65820
Goniotomy
$933$955-2%109
65756
Corneal trnspl endothelial
$1,367$1,425-4%109
66984
Xcapsl ctrc rmvl w/o ecp
$705$738-4%109
68761
Close tear duct opening
$156$164-5%109

Lowest vs national

CodeLouisianaNationalGapProv.
76512
Oph us dx b-scan
$57$70-18%109
92273
Full field erg w/i&r
$117$142-18%109
92083
Extended visual field xm
$61$73-17%109
92250
Fundus photography w/i&r
$44$53-16%109
92025
Cptrized corneal topography
$34$40-16%109

All ophthalmology codes in Louisiana

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeLouisianaNationalGap% of MedicareProvidersTINsLevel
CPT 66821
After cataract laser surgery
$386$393-2%115%109127
CPT 65820
Goniotomy
$933$955-2%129%109125
CPT 65756
Corneal trnspl endothelial
$1,367$1,425-4%138%109125
CPT 66984
Xcapsl ctrc rmvl w/o ecp
$705$738-4%152%109127
CPT 68761
Close tear duct opening
$156$164-5%109%109126
CPT 67904
Repair eyelid defect
$771$816-6%104%109126
CPT 66991
Xcapsl ctrc rmvl insj 1+
$789$840-6%136%109125
CPT 67028
Injection eye drug
$128$137-7%112%109128
CPT 67036
Removal of inner eye fluid
$1,031$1,117-8%136%109125
CPT 20610
Drain/inj joint/bursa w/o us
$64$69-8%93%109121
CPT 93000
Electrocardiogram complete
$19$21-9%123%110124
CPT 99203
Office o/p new low 30 min
$91$101-10%77%109128
CPT 67210
Treatment of retinal lesion
$591$659-10%114%109125
CPT 66982
Xcapsl ctrc rmvl cplx wo ecp
$873$981-11%138%109125
CPT 99204
Office o/p new mod 45 min
$140$158-11%79%110128
CPT 92242
Fluorescein&icg angiography
$256$288-11%76%109125
CPT 92004
Compre oph exam new pt 1/>
$110$124-11%74%109156
CPT 92012
Intrm oph exam est patient
$67$76-11%161%109156
CPT 92020
Gonioscopy
$23$26-12%87%109127
CPT 67042
Vit for macular hole
$1,318$1,494-12%138%109125
CPT 92134
Cptrz oph dx img pst sgm rta
$40$45-12%121%109127
CPT 65778
Cover eye w/membrane
$62$70-12%172%109123
CPT 67108
Repair detached retina
$1,402$1,594-12%141%109126
CPT 15823
Blepharp upr eyelid xcsv skn
$594$677-12%94%109125
CPT 92014
Compre oph exam est pt 1/>
$88$101-12%142%109156
CPT 65855
Trabeculoplasty laser surg
$269$307-12%110%109125
CPT 99214
Office o/p est mod 30 min
$94$107-13%69%110128
CPT 67840
Remove eyelid lesion
$221$253-13%165%109126
CPT 99212
Office o/p est sf 10 min
$37$43-13%62%110128
CPT 92201
Opscpy extnd rta draw uni/bi
$23$27-13%92%109127
CPT 99205
Office o/p new hi 60 min
$178$205-13%75%110128
CPT 92235
Fluorescein angrph mltiframe
$125$145-14%77%109126
CPT 92133
Cptrzd oph dx img pst sgm on
$36$42-14%119%109128
CPT 92202
Opscpy extnd on/mac draw
$14$17-14%92%109126
CPT 99213
Office o/p est low 20 min
$62$73-14%66%110128
CPT 99215
Office o/p est hi 40 min
$126$148-15%65%110128
CPT 92136
Ophthalmic biometry
$58$69-15%121%109127
CPT 92025
Cptrized corneal topography
$34$40-16%91%109127
CPT 92250
Fundus photography w/i&r
$44$53-16%119%109128
CPT 92083
Extended visual field xm
$61$73-17%95%109128
CPT 92273
Full field erg w/i&r
$117$142-17%95%109126
CPT 76512
Oph us dx b-scan
$57$70-18%117%109126

Frequently asked questions

How do Louisiana ophthalmology rates compare with the rest of the country?

Louisiana ranks 39th of 50 states with an index of 88; 0 of 42 codes are above the national median.

Which ophthalmology code has the biggest premium in Louisiana?

CPT 66821 (After cataract laser surgery), at 98% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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