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    OpenPayerNPI Medicare & MedicaidScott Lee
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    Scott Lee — Billing Profile & Reimbursement Data

    NPI 1699720946 · Pinole, CA · Ophthalmology Physician

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    Scott Lee is a ophthalmology physician provider located in Pinole, California. This profile covers 23 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
    OrganizationScott Lee
    Address1289 Pinole Valley Road
    CityPinole
    StateCA
    ZIP94564
    TaxonomyOphthalmology Physician
    NPI EnumeratedMay 24, 2006

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

    Payer SourceTotal Paid
    Medicare$416.6K
    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.

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…700$90$62.6K
    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…120$470$57.1K
    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…350$120$43.5K
    15823In 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…60$540$34.6K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.220$140$31.1K
    67904The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the…50$570$29.8K
    65820The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma.30$820$24.7K
    65778The provider places amniotic membrane on the ocular surface, similar to the placement of a contact lens.20$1,470$22.1K
    67966The provider excises damaged or diseased tissue of the eyelid that may include the edges of the lid, the lid’s inner plate, the membrane lining of the lid, or the corner where the lids come together.…40$610$22K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.60$310$19.5K

    Showing 1–10 of 23

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    23 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    669844931,25090$690$122.8K
    65778839040$1,190$104.6K
    658203811020$1,150$42.5K
    67904186030$700$37K
    158234219030$640$30.9K
    920147312,890110$100$28.7K
    920122371,620150$70$23.6K
    3120011010$1,760$22.8K
    6682131495040$270$18.4K
    921341,5832,15090$30$12.6K

    Showing 1–10 of 23

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Stanford Health CareCAGeneral Acute Care Hospital$0$264.9M
    Stanford Health CareCAGeneral Acute Care Hospital$0$46.2M
    John Muir Physician NetworkCAGeneral Practice Physician$0$27.1M
    Khosrow MehranyCASpecialist$7.7M$0
    Robert WendelCARetina Specialist (Ophthalmology) Physician$4.7M$0
    Roger GoldbergCARetina Specialist (Ophthalmology) Physician$4.6M$0
    Margaret ChangCARetina Specialist (Ophthalmology) Physician$4.3M$0
    Tony TsaiCARetina Specialist (Ophthalmology) Physician$3.9M$0
    Michael ShermanCAHematology & Oncology Physician$3.9M$0
    Clement ChowCAOphthalmology Physician$3.8M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    M Elder D D S A Professional CorporationCAOral and Maxillofacial Surgery (Dentist)$0$39.6M
    Canyon Pinole Surgery Center, LPCAAmbulatory Surgical Clinic/Center$582.5K$0
    Chao HoCAInternal Medicine Physician$249.2K$266.1K
    Stuart GourlayCASurgery Physician$121K$0
    Jeanne RoderCASpeech-Language Pathologist$26.2K$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. California Distribution
    Scott Lee — 1 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California