Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJohn Berdahl
    Ask Trek AI about this page

    John Berdahl — Billing Profile & Reimbursement Data

    NPI 1871761577 · Sioux Falls, SD · Ophthalmology Physician

    Customize your policy alerts

    Sign up for John Berdahl — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    John Berdahl is a ophthalmology physician provider located in Sioux Falls, South Dakota. 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.

    Table of contents

    Progress1 / 9

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJohn Berdahl
    Address3101 W 57th St
    CitySioux Falls
    StateSD
    ZIP57108
    TaxonomyOphthalmology Physician
    NPI EnumeratedFebruary 15, 2008

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

    Payer SourceTotal Paid
    Medicare$664K
    Medicaid$0

    Key Findings

    This provider’s public-payer mix is effectively single‑payer: total Medicare revenue is $664K and there is no Medicaid billing on file, so Medicare accounts for the entirety of reported public-program revenue. Analysts should treat Medicaid-based comparisons as not applicable for this NPI.

    Revenue is highly concentrated in a small set of cataract- and implant-related codes: the precomputed top 3 Medicare codes by revenue account for 67.3% of the provider’s total Medicare revenue, led by 66984 ($285.4K, 832 claims, 43.0%), followed by 66821 ($87.3K, 263 claims, 13.1%) and 66991 ($74.4K, 169 claims, 11.2%). This concentration indicates the practice’s Medicare dollars are driven primarily by cataract procedures and associated device work.

    The code mix indicates a surgical ophthalmology practice focused on cataract surgery, intraocular lens (IOL) procedures, and glaucoma drainage interventions: key high-revenue codes include 66984 (standard extracapsular cataract extraction with lens insertion), 66991 (insertion of IOL with one or more anterior segment aqueous drainage devices), and 66821 (YAG capsulotomy). The presence of 65756 (full corneal transplant) and drainage-device codes such as 0449T and 66174 further signals capability in corneal and glaucoma surgical care.

    One clear competitive outlier is 66991: the provider ranks #15 of 1445 nationally (99th percentile; extreme outlier) for that combined cataract + anterior segment aqueous drainage-device insertion code, which suggests far above-typical national volume for complex cataract procedures involving drainage devices. This positions the provider as a national-level high-volume clinician for that specific, higher-complexity service.

    Several additional services also show unusually high relative activity: 92136 (IOL calculations/measurements) appears with 1K claims and $31.3K revenue (4.7%) and ranks #88 of 8731 (99th percentile; extreme outlier), indicating a very high throughput of biometry/testing consistent with a busy cataract surgery pipeline. Together with the top surgical codes, this pattern is consistent with a high-volume surgical workflow where preoperative planning and device selection are routine.

    The practice also reports above-typical volumes for advanced corneal surgery: 65756 (complete corneal transplant) accounts for $59K (8.9%) with 66 claims and ranks #16 of 567 (97th percentile; notably above typical national volume). This suggests the provider performs corneal transplantation at levels well above most peers, adding a subspecialty therapeutic capability beyond routine cataract work.

    Conversely, some commonly seen service lines are at expected or modest relative levels: 66984 (standard cataract with IOL) is $285.4K (43.0%) and ranks #2187 of 15965 (86th percentile; typical, unremarkable volume), while 66821 (YAG capsulotomy) ranks #580 of 10087 (94th percentile; typical, unremarkable volume). In plain terms, routine cataract case volumes are solid but not exceptional given the national field, whereas the differentiated volume is concentrated in complex combined procedures and specialty transplants.

    Provider tenure supports the observed operational maturity: NPI enumerated 2008-02-15 (~18 years ago), which aligns with an established surgical practice and a likely stable referral base that could explain sustained high volumes in complex ophthalmic procedures. Analysts evaluating market positioning should weigh long tenure alongside the concentration in higher‑complexity codes when assessing competitive standing and referral dependencies.

    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…830$340$285.4K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.260$330$87.3K
    66991The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in…170$440$74.4K
    65756During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium.70$890$59K
    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…1,040$30$31.3K
    J7351Injection, bimatoprost, intracameral implant, 1 microgram180$160$29.2K
    66988The provider inserts an artificial lens after endoscopic cyclophotocoagulation and removing an extracapsular cataract by aspiration or use of ultrasonic waves.40$470$16.3K
    65400In this procedure, the provider excises a thin layer from the surface of the cornea, the front portion of the eye that focuses light on the lens, to remove a mass, scar tissue, or other lesion,…40$450$15.9K
    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$450$15.6K
    0449TThe provider inserts the first aqueous drainage device into the interior of the eye with its end in the subconjunctival space; the device does not include a reservoir to hold the fluid. The device…20$640$11.4K

    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
    6699121070$1,370$119.4K
    66984713040$410$67.7K
    J7351210300$160$47.7K
    6575621020$1,070$38.6K
    6582041040$1,010$37.2K
    66821530100$230$35.6K
    6698821040$890$32K
    6617431040$850$26.5K
    0449T21020$1,360$25.9K
    66982132040$580$25K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Chad LaurichSDVascular Surgery Physician$3.2M$0
    NPI 1588636484——$3.2M$0
    Ryan GeraetsSDOphthalmology Physician$3M$0
    John BormesSDOphthalmology Physician$2.6M$0
    Elizabeth AtchisonSDOphthalmology Physician$1.7M$0
    Ashar LuqmanIANephrology Physician$1.4M$0
    Taylor SlingsbySDRetina Specialist (Ophthalmology) Physician$1.4M$0
    Ty HansonSDDermatology Physician$1.2M$0
    Alexander RingeisenMNRetina Specialist (Ophthalmology) Physician$1.1M$0
    Richard ConklinSDHematology & Oncology Physician$994.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Avera MckennanSDPsychiatry Physician$0$9.1M
    Vance Thompson Vision Surgery Center Prof LLCSDAmbulatory Surgical Clinic/Center$4.5M$22.7K
    Siouxland Oral SurgerySDOral and Maxillofacial Surgery (Dentist)$0$3.9M
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$3.4M
    Anderson-smith Speech Therapy, LLCSDSpeech-Language Pathologist$0$1.9M
    Ophthalmology Ltd Eye Surgery Center L L CSDAmbulatory Surgical Clinic/Center$1.8M$16.2K
    Dakota Vision Center, LLCSDOptometrist$0$1.2M
    Usc Ambulatory Surgical Center Prof LLCSDAmbulatory Surgical Clinic/Center$1.1M$44.2K
    Avera MckennanSDPhysical Therapist$0$1M
    Encompass Mental Health, LLCSDMental Health Counselor$0$908.7K

    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. South Dakota Distribution
    John Berdahl — 2 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Dakota