Ophthalmology · Oklahoma

Ophthalmology commercial reimbursement in Oklahoma

How Oklahoma ophthalmology rates compare with the national market.

Ophthalmology in Oklahoma

42 codes · 112 sampled providers
Index vs national
85
15% below
Rank among states
44 of 50
1 = highest
Codes above national
7 of 42
median code at 88%
Providers
112
sampled

What the data shows

1

Ophthalmology ranks 44th of 50 states in Oklahoma with an index of 85 (100 = the specialty's national median), across 42 codes and 112 sampled providers.

2

Of the 42 ophthalmology codes with enough data in Oklahoma, 7 pay above the national median and 35 below; the typical code sits at 88% of the national median.

3

Largest premium over the national median: CPT 92004 (Compre oph exam new pt 1/>) at 103%; largest discount: CPT 76512 (Oph us dx b-scan) at 59%.

4

Measured against Medicare, Oklahoma ophthalmology rates have a median of 103% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeOklahomaNationalGapProv.
92004
Compre oph exam new pt 1/>
$127$124+3%112
92202
Opscpy extnd on/mac draw
$17$17+3%112
99212
Office o/p est sf 10 min
$44$43+2%112
92014
Compre oph exam est pt 1/>
$102$101+1%112
92201
Opscpy extnd rta draw uni/bi
$27$27+1%112

Lowest vs national

CodeOklahomaNationalGapProv.
76512
Oph us dx b-scan
$41$70-41%112
92235
Fluorescein angrph mltiframe
$104$145-28%112
92242
Fluorescein&icg angiography
$218$288-24%111
92250
Fundus photography w/i&r
$41$53-22%112
20610
Drain/inj joint/bursa w/o us
$55$69-21%107

All ophthalmology codes in Oklahoma

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeOklahomaNationalGap% of MedicareProvidersTINsLevel
CPT 92004
Compre oph exam new pt 1/>
$127$124+3%85%112225
CPT 92202
Opscpy extnd on/mac draw
$17$17+3%110%112214
CPT 99212
Office o/p est sf 10 min
$44$43+2%73%112220
CPT 92014
Compre oph exam est pt 1/>
$102$101+1%165%112225
CPT 92201
Opscpy extnd rta draw uni/bi
$27$27+1%107%112216
CPT 99203
Office o/p new low 30 min
$102$101+1%87%112220
CPT 99204
Office o/p new mod 45 min
$159$158+1%90%112220
CPT 99214
Office o/p est mod 30 min
$106$107-1%78%112220
CPT 99213
Office o/p est low 20 min
$72$73-1%76%112220
CPT 99215
Office o/p est hi 40 min
$146$148-1%76%112219
CPT 99205
Office o/p new hi 60 min
$202$205-2%85%112219
CPT 92020
Gonioscopy
$25$26-4%95%112216
CPT 65820
Goniotomy
$905$955-5%125%111214
CPT 15823
Blepharp upr eyelid xcsv skn
$629$677-7%99%111215
CPT 65756
Corneal trnspl endothelial
$1,322$1,425-7%133%111214
CPT 67904
Repair eyelid defect
$754$816-8%101%111215
CPT 66991
Xcapsl ctrc rmvl insj 1+
$764$840-9%131%111214
CPT 68761
Close tear duct opening
$148$164-10%103%112217
CPT 92012
Intrm oph exam est patient
$68$76-10%164%112225
CPT 67036
Removal of inner eye fluid
$998$1,117-11%131%111214
CPT 66821
After cataract laser surgery
$344$393-12%103%112216
CPT 67042
Vit for macular hole
$1,275$1,494-15%134%111214
CPT 65778
Cover eye w/membrane
$59$70-15%166%112213
CPT 66982
Xcapsl ctrc rmvl cplx wo ecp
$832$981-15%132%111215
CPT 92273
Full field erg w/i&r
$120$142-15%98%112215
CPT 92025
Cptrized corneal topography
$34$40-16%91%112215
CPT 92134
Cptrz oph dx img pst sgm rta
$38$45-16%115%112217
CPT 67210
Treatment of retinal lesion
$555$659-16%107%111214
CPT 93000
Electrocardiogram complete
$17$21-16%114%107143
CPT 67108
Repair detached retina
$1,328$1,594-17%134%111214
CPT 92133
Cptrzd oph dx img pst sgm on
$35$42-17%114%112217
CPT 67028
Injection eye drug
$113$137-17%99%112216
CPT 66984
Xcapsl ctrc rmvl w/o ecp
$607$738-18%131%112217
CPT 65855
Trabeculoplasty laser surg
$252$307-18%103%111215
CPT 92083
Extended visual field xm
$59$73-20%92%112217
CPT 92136
Ophthalmic biometry
$55$69-20%115%112216
CPT 67840
Remove eyelid lesion
$203$253-20%151%111215
CPT 20610
Drain/inj joint/bursa w/o us
$55$69-21%79%107138
CPT 92250
Fundus photography w/i&r
$41$53-22%111%112215
CPT 92242
Fluorescein&icg angiography
$218$288-24%65%111211
CPT 92235
Fluorescein angrph mltiframe
$104$145-28%64%112215
CPT 76512
Oph us dx b-scan
$41$70-41%85%112214

Frequently asked questions

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

Oklahoma ranks 44th of 50 states with an index of 85; 7 of 42 codes are above the national median.

Which ophthalmology code has the biggest premium in Oklahoma?

CPT 92004 (Compre oph exam new pt 1/>), at 103% 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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