Loading...
NPI 1255560157 · Liverpool, NY · Retina Specialist (Ophthalmology) Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Kevin Rosenberg is a retina specialist (ophthalmology) physician provider located in Liverpool, New York. This profile covers 20 Medicare and 4 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 | Kevin Rosenberg |
| Address | 200 Greenfield Pkwy |
| City | Liverpool |
| State | NY |
| ZIP | 13088 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | July 13, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4M |
| Medicaid | $306.5K |
KEVIN ROSENBERG is a retina specialist in Liverpool, NY with an NPI enumerated on 2009-07-13 (~17 years ago). Lifetime Medicare revenue on file is $4M while lifetime Medicaid revenue is $306.5K, indicating Medicare is the overwhelmingly larger revenue source for this provider.
Revenue concentration on Medicare is highly concentrated: the precomputed top three Medicare codes account for 83.3% of this provider's total Medicare revenue, driven primarily by J0178 which alone represents 72.5% of Medicare revenue ($2.9M), followed by J2777 (5.8%, $227.9K) and 67028 (5.0%, $198.5K). This concentration signals reliance on a narrow set of high-value procedural/drug codes.
The provider’s procedural mix is characteristic of a high-volume intravitreal injection and retina-imaging practice. J0178 (aflibercept) dominates Medicare billing with 4.1K claims and $2.9M revenue; complementary procedure code 67028 (intravitreal injection as an isolated procedure) and diagnostic imaging 92134 are also present, together indicating a clinic workflow centered on repeated therapeutic injections plus retinal diagnostic imaging.
On national competitive standing Medicare data show above-average to exceptional volumes for the top service lines: J0178 ranks #62 of 3204 providers nationally (98th percentile) and is described as notably above typical national volume, 67028 ranks #302 of 4255 (93rd percentile) and is also notably above typical national volume, and 92134 ranks #242 of 26868 (99th percentile) and is flagged as an extreme outlier. These rank/percentile signals identify the provider as a major national contributor for aflibercept injections and an unusually high-volume imager for retinal diagnostics.
Medicaid billing is also highly concentrated: the precomputed top three Medicaid codes account for 99.7% of this provider's total Medicaid revenue, with J0178 at 84.6% ($259.6K), 67028 at 10.6% ($32.5K), and 92134 at 4.5% ($13.8K). This mirrors the Medicare pattern and indicates the provider treats Medicaid patients under the same injection- and imaging-focused service model.
Competitive standing within the state for Medicaid is solid but not dominant: J0178 ranks #24 of 101 in-state (77th percentile), 67028 ranks #76 of 262 (71st percentile), and 92134 ranks #154 of 728 (79th percentile), all characterized as typical or unremarkable volumes in-state. In short, the provider is a strong contributor to intravitreal injection volume locally but is comparatively more prominent on Medicare at the national level than on Medicaid in-state.
The payer mix and scale imply Medicare is the principal revenue driver: lifetime Medicare revenue of $4M dwarfs lifetime Medicaid revenue of $306.5K, so operational and contracting strategies that optimize Medicare reimbursement and patient throughput will disproportionately affect overall financial performance. Medicaid appears supplementary to the practice’s volume and revenue base rather than a primary driver.
Non-procedural office visit and E/M codes compose a small portion of revenue relative to injections and imaging—examples include 92014 ($99.3K on Medicare is 2.5% of Medicare revenue) and 99214 ($36.8K on Medicare is 0.9% of Medicare revenue). This distribution emphasizes a procedure-driven business model (repeat injections and retina imaging) rather than a visit/E&M-driven outpatient practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4,140 | $690 | $2.9M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 7,860 | $30 | $227.9K |
| 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. | 2,180 | $90 | $198.5K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 990 | $120 | $118.8K |
| 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. | 3,430 | $30 | $99.3K |
| J2778 | Injection, ranibizumab, 0.1 mg | 530 | $180 | $95.9K |
| J3490 | Unclassified drugs | 50 | $1,770 | $86.6K |
| J3590 | Unclassified biologics | 40 | $1,790 | $75.3K |
| 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… | 480 | $80 | $40.6K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 410 | $90 | $36.8K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 5 | 230 | 560 | $690 | $693K |
| J2777 | 56 | 120 | 7,740 | $30 | $364.9K |
| J2778 | 34 | 70 | 510 | $180 | $131.6K |
| J2781 | 6 | 40 | 520 | $120 | $75.1K |
| J3590 | 6 | 20 | 30 | $1,430 | $72.7K |
| 67028 | 12 | 300 | 400 | $100 | $65.9K |
| J3490 | 65 | 120 | 60 | $470 | $50.8K |
| 92014 | 462 | 2,220 | 160 | $100 | $29.3K |
| 67042 | 12 | 40 | 20 | $1,030 | $22.7K |
| 99214 | 3,880 | 30,450 | 90 | $100 | $19K |
Showing 1–10 of 20
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 790 | $330 | $259.6K |
| 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. | 1,050 | $30 | $32.5K |
| 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. | 1,720 | $10 | $13.8K |
| 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… | 10 | $60 | $870 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 24 | 100 | 280 | $650 | $369.9K |
| 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… | 2,227 | 2,440 | 330 | $70 | $92.6K |
| 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. | 76 | 260 | 420 | $70 | $65.6K |
| 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. | 154 | 730 | 370 | $20 | $30K |
Other providers in the same ZIP code as Kevin Rosenberg, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Laboratory Alliance Of Central New York, LLC | NY | Clinical Medical Laboratory | $2.6M | $10.6M |
| Syracuse Asc, LLC | NY | Ambulatory Surgical Clinic/Center | $5M | $1.8M |
| Digestive Disease Center Of Central New York, LLC | NY | Ambulatory Surgical Clinic/Center | $706K | $3.6M |
| Robert Dracker | NY | Pediatrics Physician | $1.1M | $56.8K |
| Joseph Housel | NY | Dermatology Physician | $1.1M | $0 |
| Richard Stankus | NY | Allergy & Immunology Physician | $58.2K | $347K |
| Sherwin Pollock | NY | Diagnostic Radiology Physician | $349.2K | $30.3K |
| Leslie Woodcock | NY | Ophthalmology Physician | $292.4K | $0 |
| Nedim Ruhotina | NY | Urology Physician | $237K | $850 |
| Gary Leavitt | NY | Diagnostic Radiology Physician | $209.5K | $790 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.