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NPI 1437181054 · Bluefield, WV · Ophthalmology Physician
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Stephen Blaydes is a ophthalmology physician provider located in Bluefield, West Virginia. This profile covers 18 Medicare and 12 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 | Stephen Blaydes |
| Address | 1109 W Cumberland Rd |
| City | Bluefield |
| State | WV |
| ZIP | 24701 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $406K |
| Medicaid | $375.8K |
This provider’s Medicare billing is heavily concentrated in a small set of ophthalmic services: the top three Medicare codes (66984, 92014, 92012) account for 73.9% of total Medicare revenue, and the single code 66984 alone generates $179.5K (43.8% of Medicare revenue). Those top Medicare items are predominantly cataract surgery and comprehensive eye exams, indicating the practice’s primary service line is operative cataract care with associated pre/post-op ophthalmologic evaluations.
Medicaid revenue shows an even stronger concentration in cataract surgery: the top three Medicaid codes (66984, 92004, 92012) account for 81.6% of total Medicaid revenue, with 66984 producing $205.3K and representing 54.5% of the provider’s Medicaid revenue. This concentration implies the provider relies on high-volume cataract procedures to drive Medicaid revenue, supported by new-patient comprehensive evaluations (92004) and established-patient exams (92012).
The provider’s payer mix is nearly balanced in scale: Total Medicare revenue is $406K while total Medicaid revenue is $375.8K, so both payers materially contribute to the practice’s earnings rather than one being dominant. Given similar totals and the code mix, the practice appears to serve both Medicare and Medicaid populations with a parallel focus on surgical cataract services and follow-up ophthalmic care.
Competitive standing on Medicare is elevated for several core codes: 66984 ranks #52 of 15965 providers nationally (100th percentile; extreme outlier), 92004 ranks #118 of 26467 (100th percentile; extreme outlier), and 92012 and 92014 both rank in high national percentiles (92012: #405 of 17177, 98th percentile; 92014: #1558 of 35415, 96th percentile). These rankings indicate the provider is a major national-volume performer for cataract surgery and comprehensive ophthalmologic exams compared with peers.
State-level competitiveness for Medicaid is similarly strong for surgical services: 66984 ranks #2 of 22 providers in-state (95th percentile; notably above typical state volume), and 92136 (IOL biometry) ranks #2 of 13 providers in-state (92th percentile; notably above typical state volume). Those in-state ranks show the provider is a leading cataract surgeon in West Virginia Medicaid billing, capturing an outsized share of surgical Medicaid activity.
Operational signals from the code mix point to a surgical cataract-centric practice with integrated diagnostic services: high volumes of 66984 (cataract extraction with IOL insertion) are accompanied by substantial counts of 92136 (IOL measurement) and both new and established comprehensive exam codes (92004, 92014, 92012). This pattern is consistent with a practice that performs many cataract procedures and manages preoperative planning and postoperative follow-up in-house rather than referring those elements out.
Payment-profile nuances are noteworthy: the average paid per-claim for 66984 differs between payers in the datasets provided ($27 avg paid/claim on Medicare vs. $115 avg paid/claim on Medicaid), while claim volumes for that code are high on both payers (Medicare 6.6K claims; Medicaid 1.8K claims). Those differences in per-claim payments and the high claim counts suggest materially different reimbursement dynamics across payers even as the clinical service driving revenue is the same.
The provider is an established practitioner: the NPI was enumerated 2006-07-06 (~20 years ago), which supports a long-tenure practice capable of sustaining high procedural volumes. Long tenure plus the extreme national and state ranks on key surgical and exam codes together indicate a deeply embedded cataract surgery operation with stable referral and case flow.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The 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… | 6,650 | $30 | $179.5K |
| 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… | 1,030 | $70 | $71.2K |
| 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… | 1,090 | $50 | $52.4K |
| 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. | 500 | $80 | $41.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 90 | $240 | $20.3K |
| 92136 | The 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… | 800 | $20 | $15.3K |
| 66982 | The 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… | 240 | $40 | $8.2K |
| 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. | 250 | $20 | $6.1K |
| 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… | 160 | $30 | $5.2K |
| 92133 | The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both… | 160 | $20 | $3.3K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 1 | 90 | 210 | $70 | $60.7K |
| 66982 | 1 | 30 | 30 | $400 | $17.9K |
| 92014 | 3 | 180 | 120 | $70 | $16.3K |
| 66821 | 14 | 50 | 50 | $190 | $16.2K |
| 99214 | 2,396 | 2,740 | 100 | $70 | $11.8K |
| 99213 | 2,274 | 2,860 | 80 | $50 | $7.5K |
| 92012 | 1 | 80 | 70 | $50 | $7.2K |
| 92136 | 2 | 40 | 160 | $20 | $6.1K |
| 92134 | 22 | 160 | 60 | $30 | $5.4K |
| 92004 | 1 | 150 | 40 | $80 | $4.7K |
Showing 1–10 of 18
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The 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… | 1,790 | $120 | $205.3K |
| 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. | 1,250 | $50 | $64.9K |
| 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… | 1,330 | $30 | $37.3K |
| 92136 | The 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… | 1,460 | $20 | $33.7K |
| 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… | 700 | $30 | $23K |
| 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… | 70 | $40 | $2.9K |
| 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. | 800 | $1 | $2.4K |
| 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… | 30 | $70 | $2.2K |
| 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. | 110 | $20 | $1.8K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 50 | $30 | $1.3K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
12 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… | 1,079 | 1,270 | 1,240 | $30 | $245K |
| 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… | 920 | 1,030 | 890 | $50 | $221K |
| 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… | 256 | 340 | 140 | $90 | $97.5K |
| 66984 | The 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… | 2 | 20 | 100 | $180 | $81.5K |
| 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. | 19 | 30 | 390 | $30 | $79.1K |
| 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… | 61 | 140 | 550 | $70 | $70.2K |
| 99203 | The provider sees a new 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 provider… | 423 | 440 | 110 | $60 | $57.2K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 435 | 540 | 320 | $20 | $43.2K |
| 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. | 17 | 120 | 270 | $80 | $42.5K |
| 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… | 7 | 40 | 110 | $40 | $22.4K |
Showing 1–10 of 12
Other providers in the same ZIP code as Stephen Blaydes, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bluefield Hospital Company LLC | WV | General Acute Care Hospital | $0 | $12.4M |
| Bluefield Rescue Squad Inc | WV | Land Ambulance | $770.9K | $7.6M |
| Community Action South Eastern Wv | WV | Home Health Agency | $0 | $2.3M |
| Bio-medical Applications Of West Virginia, Inc. | WV | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $2M |
| Bluestone Health Association, Inc. | WV | Federally Qualified Health Center (FQHC) | $0 | $1.8M |
| Island Medical Bluefield LLC | WV | Emergency Medicine Physician | $0 | $1.4M |
| Icp West Virginia LLC | WV | Emergency Medicine Physician | $0 | $1.4M |
| George Britton | WV | Optometrist | $66.6K | $109.9K |
| Khalid Razzaq | WV | Neurology Physician | $115.4K | $11.9K |
| Shariful Alam | WV | Family Medicine Physician | $81.9K | $0 |
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