Ophthalmology · Nevada

Ophthalmology commercial reimbursement in Nevada

How Nevada ophthalmology rates compare with the national market.

Ophthalmology in Nevada

42 codes · 113 sampled providers
Index vs national
88
12% below
Rank among states
37 of 50
1 = highest
Codes above national
0 of 42
median code at 89%
Providers
113
sampled

What the data shows

1

Ophthalmology ranks 37th of 50 states in Nevada with an index of 88 (100 = the specialty's national median), across 42 codes and 113 sampled providers.

2

Of the 42 ophthalmology codes with enough data in Nevada, 0 pay above the national median and 42 below; the typical code sits at 89% of the national median.

3

Largest premium over the national median: CPT 99203 (Office o/p new low 30 min) at 95%; largest discount: CPT 76512 (Oph us dx b-scan) at 77%.

4

Measured against Medicare, Nevada ophthalmology rates have a median of 105% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNevadaNationalGapProv.
99203
Office o/p new low 30 min
$96$101-5%113
92133
Cptrzd oph dx img pst sgm on
$40$42-5%112
92134
Cptrz oph dx img pst sgm rta
$43$45-5%112
92273
Full field erg w/i&r
$135$142-5%112
92136
Ophthalmic biometry
$65$69-5%112

Lowest vs national

CodeNevadaNationalGapProv.
76512
Oph us dx b-scan
$54$70-23%112
67210
Treatment of retinal lesion
$526$659-20%111
67042
Vit for macular hole
$1,215$1,494-19%111
66982
Xcapsl ctrc rmvl cplx wo ecp
$802$981-18%111
66991
Xcapsl ctrc rmvl insj 1+
$697$840-17%111

All ophthalmology codes in Nevada

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNevadaNationalGap% of MedicareProvidersTINsLevel
CPT 99203
Office o/p new low 30 min
$96$101-5%82%113116
CPT 92133
Cptrzd oph dx img pst sgm on
$40$42-5%131%112111
CPT 92134
Cptrz oph dx img pst sgm rta
$43$45-5%130%112112
CPT 92273
Full field erg w/i&r
$135$142-5%109%112113
CPT 92136
Ophthalmic biometry
$65$69-5%135%112112
CPT 99204
Office o/p new mod 45 min
$146$158-8%82%113115
CPT 92025
Cptrized corneal topography
$37$40-8%100%112111
CPT 68761
Close tear duct opening
$151$164-8%106%112114
CPT 99213
Office o/p est low 20 min
$67$73-8%71%113115
CPT 92201
Opscpy extnd rta draw uni/bi
$24$27-8%97%112113
CPT 99212
Office o/p est sf 10 min
$39$43-8%66%113116
CPT 92012
Intrm oph exam est patient
$69$76-9%166%112134
CPT 99214
Office o/p est mod 30 min
$97$107-9%72%113115
CPT 92202
Opscpy extnd on/mac draw
$15$17-9%97%112113
CPT 92020
Gonioscopy
$24$26-9%90%112115
CPT 99205
Office o/p new hi 60 min
$186$205-9%79%113116
CPT 92083
Extended visual field xm
$66$73-10%103%112114
CPT 92250
Fundus photography w/i&r
$47$53-11%127%112115
CPT 92242
Fluorescein&icg angiography
$256$288-11%76%111111
CPT 65820
Goniotomy
$848$955-11%117%111113
CPT 99215
Office o/p est hi 40 min
$131$148-11%68%113114
CPT 92235
Fluorescein angrph mltiframe
$128$145-11%79%112115
CPT 92004
Compre oph exam new pt 1/>
$108$124-13%72%112134
CPT 67840
Remove eyelid lesion
$220$253-13%164%111113
CPT 20610
Drain/inj joint/bursa w/o us
$60$69-13%87%110107
CPT 66821
After cataract laser surgery
$341$393-13%102%112114
CPT 92014
Compre oph exam est pt 1/>
$87$101-13%141%112134
CPT 15823
Blepharp upr eyelid xcsv skn
$584$677-14%92%111113
CPT 67904
Repair eyelid defect
$699$816-14%94%111113
CPT 93000
Electrocardiogram complete
$18$21-15%116%111113
CPT 67036
Removal of inner eye fluid
$941$1,117-16%124%111114
CPT 65855
Trabeculoplasty laser surg
$259$307-16%105%111113
CPT 65756
Corneal trnspl endothelial
$1,197$1,425-16%121%111112
CPT 66984
Xcapsl ctrc rmvl w/o ecp
$618$738-16%134%112114
CPT 67028
Injection eye drug
$114$137-16%100%112115
CPT 65778
Cover eye w/membrane
$58$70-17%163%110104
CPT 67108
Repair detached retina
$1,324$1,594-17%133%111114
CPT 66991
Xcapsl ctrc rmvl insj 1+
$697$840-17%120%111112
CPT 66982
Xcapsl ctrc rmvl cplx wo ecp
$802$981-18%127%111113
CPT 67042
Vit for macular hole
$1,215$1,494-19%127%111113
CPT 67210
Treatment of retinal lesion
$526$659-20%102%111113
CPT 76512
Oph us dx b-scan
$54$70-23%110%112113

Frequently asked questions

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

Nevada ranks 37th 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 Nevada?

CPT 99203 (Office o/p new low 30 min), at 95% 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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