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NPI 1053679886 · Bozeman, MT · Retina Specialist (Ophthalmology) Physician
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Marc Comaratta is a retina specialist (ophthalmology) physician provider located in Bozeman, Montana. This profile covers 23 Medicare and 7 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Marc Comaratta |
| Address | 1940 W Dickerson St Ste 103 |
| City | Bozeman |
| State | MT |
| ZIP | 59718 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | April 30, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $124.7K |
Medicare is the dominant payer for MARC COMARATTA by scale: total Medicare revenue is $1.2M versus total Medicaid revenue of $124.7K, so the provider’s billed volume and dollars are materially weighted toward Medicare patients. The NPI was enumerated on 2012-04-30 (~14 years ago), indicating an established billing history that is primarily Medicare-driven.
The provider’s Medicare revenue is concentrated in intravitreal drug administration and retina procedures: the top three Medicare codes by revenue are J2778, J0178, and J2777 and the precomputed top-3 codes account for 55.0% of this provider's total Medicare revenue. These codes (ranibizumab, aflibercept, faricimab) plus procedure codes such as 67028 and diagnostic code 92134 indicate a service mix centered on anti-VEGF biologic injections, vitreous injections, and retinal imaging consistent with a retina specialist practice.
Medicaid revenue is even more tightly concentrated: the precomputed top-3 Medicaid codes account for 90.8% of the provider’s total Medicaid revenue, led by 67028 (41.0%), 92134 (37.7%), and 92014 (12.1%). This pattern shows Medicaid dollars are focused almost entirely on procedural injection services and retina imaging/exams, with relatively little ancillary E/M or other service mix generating revenue.
On national Medicare benchmarks the provider shows divergent standing across different service lines: 92134 is an extreme outlier (ranks #536 of 26868 providers nationally, 98th percentile) and 92014 is notably above typical national volume (ranks #1047 of 35415, 97th percentile), signaling unusually high imaging and comprehensive exam throughput. By contrast, anti-VEGF billing ranks are modest to typical (J2778 at the 74th percentile, J0178 at the 30th percentile, J2777 at the 35th percentile), suggesting high imaging/exam volume but only typical national injection volumes.
Within Montana Medicaid comparisons the provider is a modest in-state participant rather than a dominant player: 67028 ranks #6 of 11 providers in-state (50th percentile) and 92134 ranks #7 of 16 (60th percentile), while 92014 ranks #98 of 133 (27th percentile). Those in-state ranks indicate competitive but not leading Medicaid positioning for the same retina-focused services that drive Medicare revenue.
Reimbursement mix shows materially higher per-claim Medicare payments for some biologics compared with Medicaid procedural rates: among Medicare line items, J0178 has an avg paid/claim of $688 while J2778 is $174 and J2777 is $29; for Medicaid, 67028 avg paid/claim is $63 and 92134 avg paid/claim is $27. This suggests that a substantial portion of Medicare revenue is driven by higher-priced drug administrations, while Medicaid revenue comes predominantly from lower-paid procedural and imaging services.
Operationally, the code mix—heavy on intravitreal injections, OCT imaging (92134), and comprehensive ophthalmologic exams (92014)—is consistent with an ambulatory retina practice that likely relies on throughput of injections and imaging to generate revenue. Payers and contracting teams should view this provider as a procedure- and drug-driven practice where capacity for regular injection clinics and imaging services is a core business capability.
Given the provider’s tenure (NPI enumerated 2012-04-30, ~14 years ago) combined with concentrated revenue streams (Medicare top-3 = 55.0%; Medicaid top-3 = 90.8%), the practice appears stable and specialized but also revenue-concentrated; payers evaluating risk or network value should consider both the high dependence on a few drug/procedure codes and the exceptionally high imaging/exam volumes when assessing utilization patterns or contracting levers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 1,390 | $170 | $241.9K |
| J0178 | Injection, aflibercept, 1 mg | 330 | $690 | $225.7K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 6,720 | $30 | $194.9K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 1,220 | $90 | $111.1K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 1,240 | $90 | $110.3K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 2,720 | $30 | $81.6K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 390 | $160 | $62.3K |
| J9035 | Injection, bevacizumab, 10 mg | 700 | $60 | $38.7K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 20 | $890 | $20.5K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 310 | $60 | $19.5K |
Showing 1–10 of 23
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 13 | 20 | 460 | $680 | $663.4K |
| J2777 | 7 | 10 | 10,170 | $30 | $351.2K |
| J2778 | 1 | 10 | 1,390 | $170 | $241.4K |
| 67028 | 6 | 20 | 390 | $90 | $73.7K |
| J7312 | 1 | 10 | 300 | $160 | $47K |
| 67042 | 2 | 10 | 20 | $1,140 | $22.8K |
| 92014 | 5 | 170 | 190 | $80 | $22.7K |
| 67108 | 6 | 10 | 10 | $1,140 | $20.5K |
| 67039 | 1 | 10 | 30 | $760 | $19.1K |
| 67036 | 2 | 10 | 10 | $1,160 | $16.2K |
Showing 1–10 of 23
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 810 | $60 | $51K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 1,740 | $30 | $47K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 170 | $90 | $15K |
| J9035 | Injection, bevacizumab, 10 mg | 230 | $40 | $9.7K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 20 | $70 | $1.1K |
| 92225 | N/A | 30 | $10 | $350 |
| 92226 | N/A | 20 | $10 | $300 |
How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Montana median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 482 | 520 | 730 | $40 | $196.4K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 98 | 130 | 600 | $90 | $120.9K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 6 | 10 | 810 | $50 | $52.4K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 7 | 20 | 1,300 | $20 | $28.6K |
| J9035 | Injection, bevacizumab, 10 mg | 5 | 10 | 240 | $40 | $21.9K |
| 92225 | N/A | 2 | 10 | 90 | $20 | $1.6K |
| 92226 | N/A | 2 | 10 | 80 | $10 | $1K |
Other providers in the same ZIP code as Marc Comaratta, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Wojj Pediatric Dentistry | MT | Dental Clinic/Center | $0 | $3.3M |
| Smiles Across Montana | MT | Dental Hygienist | $0 | $1.9M |
| West Bozeman Surgery Center, LLC | MT | Ambulatory Surgical Clinic/Center | $1.9M | $55K |
| Psychiatry Associates PC | MT | Psychiatry Physician | $0 | $1.4M |
| Foundation Therapy Services Inc | MT | Speech-Language Pathologist | $0 | $1.1M |
| Lincare Inc. | MT | Durable Medical Equipment & Medical Supplies | $0 | $1M |
| Montana Psychiatry, PLLC | MT | Psychiatry Physician | $0 | $1M |
| Kenneth Olson | MT | Addiction Psychiatry Physician | $29.3K | $809.9K |
| Aaron Bruce | MT | Dermatology Physician | $682.7K | $0 |
| Russell Swan | MT | Ophthalmology Physician | $560K | $0 |
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