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    v1.0.28
    OpenPayerNPI Medicare & MedicaidEfthemios Raphtis
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    Efthemios Raphtis — Billing Profile & Reimbursement Data

    NPI 1356379259 · Rochester, MI · Ophthalmology Physician

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    Efthemios Raphtis is a ophthalmology physician provider located in Rochester, Michigan. This profile covers 15 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationEfthemios Raphtis
    Address432 W. University Dr.
    CityRochester
    StateMI
    ZIP48307
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 29, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$307.2K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    66984The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…220$400$86.4K
    92014An 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…900$80$70.9K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.120$230$28.9K
    66982The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…40$570$24.6K
    99214The 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…240$90$22.4K
    92012For 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…340$60$20.1K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.120$90$10.9K
    99204The 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…90$120$10K
    92083The 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…230$40$9.4K
    92136The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…270$30$7.8K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    669848348070$470$69.5K
    669822913030$630$22.2K
    92014231,080100$80$14.8K
    668212831040$230$13.4K
    992142,79515,47080$80$11.4K
    9213431482060$30$7.1K
    920123846050$60$6.8K
    992136,41514,81060$60$6.6K
    838614180140$20$4.8K
    992045426,28030$110$4.2K

    Showing 1–10 of 15

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Efthemios Raphtis, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Balian Eye Center, LLCMIOphthalmologic Surgery Clinic/Center$269.2K$0
    Brian MahalakALOptometrist$99K$0

    Nearby Providers

    Other providers in the same ZIP code as Efthemios Raphtis, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Henry Ford Health Rochester HospitalMIGeneral Acute Care Hospital$0$12M
    Pediatric Consultants Of Troy, P.C.MIPediatrics Physician$0$6.1M
    Osi, LLCMIAmbulatory Surgical Clinic/Center$1.8M$0
    Rochester Endoscopy & Surgery Center, L.L.C.MIAmbulatory Surgical Clinic/Center$1.2M$1.4K
    Ayad AbrouMIMOHS-Micrographic Surgery Physician$1.1M$0
    David ByrdMIMOHS-Micrographic Surgery Physician$829.3K$0
    Delfin SantosMIRheumatology Physician$743K$0
    Zakwan MahjoubMIInterventional Cardiology Physician$687K$0
    Mukesh ShahMIHematology & Oncology Physician$619.3K$0
    Farah Dawood-farahMIEndocrinology, Diabetes & Metabolism Physician$533.3K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Michigan Distribution
    Efthemios Raphtis — 1 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Michigan