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NPI 1265435226 · Staunton, VA · Ophthalmology Physician
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Marc Shields is a ophthalmology physician provider located in Staunton, Virginia. This profile covers 24 Medicare and 1 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 Shields |
| Address | 1500 Commerce Rd |
| City | Staunton |
| State | VA |
| ZIP | 24401 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 24, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $262.2K |
| Medicaid | $210 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,430 | $80 | $112.7K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 420 | $60 | $25.4K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 30 | $670 | $18.7K |
| 92083 | The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended… | 290 | $40 | $12.7K |
| 14060 | The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less. | 20 | $580 | $9.9K |
| 67903 | The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove an obstruction to a patient’s vision. He accesses the… | 20 | $520 | $9.8K |
| 99204 | The provider sees a new 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 provider… | 80 | $110 | $9K |
| 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… | 100 | $90 | $8.8K |
| 68840 | This procedure is the probing of the lacrimal canaliculi with or without irrigation. | 70 | $110 | $7.3K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 70 | $90 | $6.3K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 15823 | 20 | 30 | 50 | $530 | $34.5K |
| 92014 | 51 | 870 | 170 | $80 | $32.8K |
| 66821 | 208 | 230 | 60 | $210 | $23K |
| 99214 | 7,600 | 12,890 | 140 | $80 | $21K |
| 14060 | 42 | 60 | 30 | $570 | $17K |
| 92012 | 51 | 430 | 80 | $60 | $11.9K |
| 67917 | 12 | 10 | 20 | $480 | $11.2K |
| 67903 | 2 | 10 | 20 | $540 | $10.8K |
| 99213 | 9,383 | 12,440 | 90 | $60 | $10K |
| 92134 | 249 | 680 | 70 | $30 | $9.7K |
Showing 1–10 of 24
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 20 | $10 | $210 |
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 457 | 500 | 350 | $10 | $15.3K |
Other providers in the same ZIP code as Marc Shields, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Valley Community Services Board | VA | Community/Behavioral Health Agency | $0 | $59.1M |
| Sunny Haven Residental Services | VA | Intellectual and/or Developmental Disabilities Residential Treatment Facility | $0 | $12.4M |
| Care Advantage, Inc. | VA | Home Health Agency | $0 | $11.2M |
| Staunton Augusta County First Aid And Rescue Squad Inc | VA | Land Ambulance | $769.7K | $1.1M |
| Timothy Kane | VA | Psychiatry Physician | $429.4K | $103.4K |
| Kevin Miller | VA | Dermatology Physician | $436.2K | $0 |
| Thomas Zumsteg | VA | Diagnostic Radiology Physician | $253.3K | $500 |
| Jane Lynch | VA | Dermatopathology Physician | $240.2K | $0 |
| Theodore Mckee | VA | Podiatrist | $127K | $0 |
| Ronald Lowman | VA | Chiropractor | $99.8K | $0 |
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