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NPI 1669475281 · Merrillville, IN · Ophthalmology Physician
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Christopher Pelzek is a ophthalmology physician provider located in Merrillville, Indiana. This profile covers 20 Medicare and 2 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 | Christopher Pelzek |
| Address | 8679 Connecticut St |
| City | Merrillville |
| State | IN |
| ZIP | 46410 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 27, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $2K |
Medicare dominates this provider’s payer mix: reported lifetime Medicare revenue is $1.5M versus Medicaid revenue of $2K, making the practice effectively Medicare-focused with negligible Medicaid scale. The disparity indicates that business and operational priorities are likely driven by Medicare reimbursement and patient flows rather than by Medicaid volume.
Medicare revenue is highly concentrated in a small set of services: the precomputed top three Medicare codes (J0178, J2777, 99214) account for 67.2% of this provider’s Medicare revenue. The single largest line is J0178 ($597.4K, 40.9% of Medicare revenue), followed by J2777 ($212.3K, 14.5%) and 99214 ($173.4K, 11.9%), indicating that anti-VEGF drug administration plus E/M services are the primary revenue drivers.
The code mix points to a retina‑focused ophthalmology practice that combines high-volume intravitreal drug therapy with diagnostic imaging and some surgical procedures. High revenue from J0178, J2778, J2777 and measurable volumes of 92235, 92134 and 67028 suggest routine anti‑VEGF injections, OCT/angiography imaging, and occasional office‑based retinal procedures are central to operations.
Clinical-volume standing is mixed across codes: 99214 is labeled an "extreme outlier, far above typical national volume," signaling unusually high E/M visit volume relative to peers and strong longitudinal care of established patients. By contrast, J0178 (55th percentile, "typical, unremarkable volume") and J2777 (39th percentile, "typical, unremarkable volume") are at or below median national participation, while 92235 and 92134 rank in the upper percentiles (97th and 95th respectively, "notably above typical national volume"), indicating above-average diagnostic imaging throughput.
Medicaid activity is minimal and tightly concentrated: the precomputed top three Medicaid codes account for 100.0% of Medicaid revenue, and the two listed codes (92014 at 64.8% and 92226 at 35.2%) together represent the entirety of the $2K Medicaid total. In-state ranks for these Medicaid codes (92014 at 532/685, 22nd percentile and 92226 at 8/12, 27th percentile) indicate only modest Medicaid presence in the state network.
The practice’s revenue profile is sensitive to drug and reimbursement dynamics because a large share of Medicare revenue derives from drug administration codes (notably J0178 as the top single revenue line). Any material changes in reimbursement policy for J0178, J2777 or related injection administration could materially affect topline Medicare revenue given the concentration in those codes.
Procedure-level data show a mix of office procedures and selective surgery: smaller but present revenues from vitrectomy and membrane procedures (e.g., 67041 $17.3K and 67042 $9.3K) indicate occasional surgical interventions complementing the dominant injection and imaging workload. This mix supports a practice model that performs primarily clinic‑based retinal therapy with intermittent operative cases.
The provider has a long active tenure with an NPI enumerated on 2005-05-27 (~21 years ago), consistent with an established local practice presence; combined with the high 99214 volume, this tenure suggests deep ongoing care relationships with established Medicare patients rather than a transient or newly established operation.
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 | 860 | $690 | $597.4K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 7,320 | $30 | $212.3K |
| 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… | 1,950 | $90 | $173.4K |
| J2778 | Injection, ranibizumab, 0.1 mg | 780 | $180 | $144.1K |
| 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. | 950 | $100 | $90.6K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 570 | $100 | $57.6K |
| 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. | 1,810 | $30 | $52.5K |
| 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… | 240 | $120 | $27.6K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 20 | $910 | $17.3K |
| 92202 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 1,300 | $10 | $14.3K |
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 | 29 | 60 | 830 | $690 | $868.8K |
| J2777 | 18 | 40 | 6,750 | $30 | $395.6K |
| J2778 | 4 | 10 | 560 | $180 | $150K |
| 67028 | 33 | 80 | 550 | $80 | $78.6K |
| 67042 | 14 | 20 | 20 | $1,310 | $47K |
| J3590 | 31 | 50 | 220 | $60 | $24.5K |
| 67041 | 5 | 10 | 20 | $1,000 | $22K |
| J9035 | 15 | 30 | 200 | $50 | $19.2K |
| 92235 | 2 | 40 | 90 | $100 | $15.8K |
| 99214 | 14 | 10,540 | 110 | $80 | $15.5K |
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.
2 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… | 40 | $30 | $1.3K |
| 92226 | N/A | 30 | $30 | $700 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 532 | 690 | 360 | $70 | $110.9K |
| 92226 | N/A | 8 | 10 | 170 | $10 | $15.6K |
Other providers in the same ZIP code as Christopher Pelzek, ranked by combined Medicare and Medicaid revenue.
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