Ophthalmology · Mississippi

Ophthalmology commercial reimbursement in Mississippi

How Mississippi ophthalmology rates compare with the national market.

Ophthalmology in Mississippi

42 codes · 103 sampled providers
Index vs national
110
10% above
Rank among states
21 of 50
1 = highest
Codes above national
30 of 42
median code at 111%
Providers
103
sampled

What the data shows

1

Ophthalmology ranks 21st of 50 states in Mississippi with an index of 110 (100 = the specialty's national median), across 42 codes and 103 sampled providers.

2

Of the 42 ophthalmology codes with enough data in Mississippi, 30 pay above the national median and 12 below; the typical code sits at 111% of the national median.

3

Largest premium over the national median: CPT 67028 (Injection eye drug) at 158%; largest discount: CPT 92242 (Fluorescein&icg angiography) at 84%.

4

Measured against Medicare, Mississippi ophthalmology rates have a median of 138% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMississippNationalGapProv.
67028
Injection eye drug
$216$137+58%103
65855
Trabeculoplasty laser surg
$433$307+41%103
67840
Remove eyelid lesion
$357$253+41%103
76512
Oph us dx b-scan
$95$70+36%103
65778
Cover eye w/membrane
$95$70+35%102

Lowest vs national

CodeMississippNationalGapProv.
92242
Fluorescein&icg angiography
$243$288-16%103
99205
Office o/p new hi 60 min
$183$205-11%103
99204
Office o/p new mod 45 min
$142$158-10%103
99215
Office o/p est hi 40 min
$134$148-10%103
99213
Office o/p est low 20 min
$66$73-9%103

All ophthalmology codes in Mississippi

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMississippiNationalGap% of MedicareProvidersTINsLevel
CPT 67028
Injection eye drug
$216$137+58%189%103160
CPT 65855
Trabeculoplasty laser surg
$433$307+41%177%103160
CPT 67840
Remove eyelid lesion
$357$253+41%266%103158
CPT 76512
Oph us dx b-scan
$95$70+36%195%103157
CPT 65778
Cover eye w/membrane
$95$70+35%265%102123
CPT 67210
Treatment of retinal lesion
$890$659+35%172%103159
CPT 67042
Vit for macular hole
$1,972$1,494+32%207%103159
CPT 93000
Electrocardiogram complete
$27$21+31%178%102155
CPT 67108
Repair detached retina
$2,084$1,594+31%210%103159
CPT 66984
Xcapsl ctrc rmvl w/o ecp
$942$738+28%204%103160
CPT 67904
Repair eyelid defect
$1,027$816+26%138%103158
CPT 20610
Drain/inj joint/bursa w/o us
$85$69+22%123%102154
CPT 15823
Blepharp upr eyelid xcsv skn
$825$677+22%130%103158
CPT 66982
Xcapsl ctrc rmvl cplx wo ecp
$1,176$981+20%186%103160
CPT 92250
Fundus photography w/i&r
$63$53+20%170%103158
CPT 92136
Ophthalmic biometry
$81$69+18%169%103158
CPT 68761
Close tear duct opening
$189$164+15%132%103159
CPT 67036
Removal of inner eye fluid
$1,283$1,117+15%169%103160
CPT 65756
Corneal trnspl endothelial
$1,632$1,425+15%165%103160
CPT 66821
After cataract laser surgery
$443$393+13%132%103160
CPT 92202
Opscpy extnd on/mac draw
$19$17+11%119%103158
CPT 92201
Opscpy extnd rta draw uni/bi
$29$27+10%116%103158
CPT 65820
Goniotomy
$1,029$955+8%142%103160
CPT 92025
Cptrized corneal topography
$43$40+8%116%103158
CPT 92083
Extended visual field xm
$78$73+7%122%103158
CPT 92012
Intrm oph exam est patient
$80$76+6%193%103175
CPT 92273
Full field erg w/i&r
$150$142+6%122%103157
CPT 66991
Xcapsl ctrc rmvl insj 1+
$878$840+4%151%103158
CPT 92133
Cptrzd oph dx img pst sgm on
$43$42+2%141%103158
CPT 92235
Fluorescein angrph mltiframe
$148$145+2%91%103157
CPT 92020
Gonioscopy
$26$26-1%98%102159
CPT 92134
Cptrz oph dx img pst sgm rta
$44$45-1%135%103158
CPT 92004
Compre oph exam new pt 1/>
$121$124-2%81%103175
CPT 92014
Compre oph exam est pt 1/>
$99$101-2%159%103175
CPT 99212
Office o/p est sf 10 min
$40$43-5%68%103160
CPT 99203
Office o/p new low 30 min
$93$101-8%79%103160
CPT 99214
Office o/p est mod 30 min
$98$107-9%72%103160
CPT 99213
Office o/p est low 20 min
$66$73-9%69%103160
CPT 99215
Office o/p est hi 40 min
$134$148-9%70%103160
CPT 99204
Office o/p new mod 45 min
$142$158-10%80%103160
CPT 99205
Office o/p new hi 60 min
$183$205-11%77%103160
CPT 92242
Fluorescein&icg angiography
$243$288-16%72%103154

Frequently asked questions

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

Mississippi ranks 21st of 50 states with an index of 110; 30 of 42 codes are above the national median.

Which ophthalmology code has the biggest premium in Mississippi?

CPT 67028 (Injection eye drug), at 158% 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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