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NPI 1912212788 · La Crosse, WI · Ophthalmology Physician
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Cindy Calderon is a ophthalmology physician provider located in La Crosse, Wisconsin. This profile covers 20 Medicare and 4 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 | Cindy Calderon |
| Address | 1836 South Ave |
| City | La Crosse |
| State | WI |
| ZIP | 54601 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | August 17, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $897.7K |
| Medicaid | $4.1K |
Practice appears oriented to medical retina and office-based ophthalmology: the largest Medicare revenue drivers are intravitreal injections and comprehensive eye visits, with J0178 (aflibercept) at $288.3K (32.1% of Medicare revenue), J2777 (faricimab) at $191.5K (21.3%), and 92014 (established comprehensive eye exam) at $105.6K (11.8%); those top three codes together account for 65.2% of Medicare revenue, signaling a clinical mix focused on anti-VEGF therapy plus routine ophthalmic care. This combination of high-value drug injections and frequent comprehensive exams is consistent with a practice managing chronic retinal disease in an outpatient setting.
Revenue is highly concentrated within Medicare and within a few codes: total Medicare revenue in the public datasets is $897.7K while total Medicaid revenue is $4.1K, and the provider’s top three Medicaid codes (92014, 67028, 92134) account for 96.7% of her Medicaid revenue. On Medicaid the provider’s activity is almost entirely driven by 92014 (48.3% of Medicaid revenue) and 67028 (32.3%), showing that the small Medicaid footprint is likewise concentrated in exams and injections.
Public-payer mix is effectively Medicare-dominant: Medicare revenue of $897.7K dwarfs Medicaid revenue of $4.1K, so in the available public payer data this clinician functions as a predominantly Medicare-serving ophthalmologist. Analysts should treat Medicaid volumes as negligible relative to Medicare when modeling payer exposure or negotiating managed-care arrangements based on these data.
92014 (comprehensive established exam) is a true outlier on Medicare relative to national peers: the code ranks #1702 of 35415 providers nationally (95th percentile) and is described as "notably above typical national volume," indicating this provider delivers established comprehensive exams at a materially higher rate than most ophthalmologists. That elevated 92014 volume likely contributes to steady office throughput and supports recurring follow-up for retinal patients receiving injections.
By contrast, the top retinal drug and injection codes are moderate compared with national injection providers: J0178 ranks #2095 of 3204 (34th percentile) and J2777 ranks #1324 of 2039 (35th percentile), both labeled as "typical, unremarkable volume." In practical terms, anti-VEGF and newer biologic injection activity generate the largest single revenue lines but the provider is a modest participant in national injection volumes rather than a high-volume injection center.
Retinal diagnostics and imaging are meaningful in the mix and show elevated national placement for some services: 92134 (OCT) contributes $41.1K (4.6% of Medicare revenue) and ranks #1921 of 26868 providers nationally (93rd percentile), while 92201 ranks #218 of 2619 (92nd percentile). The combination of above-typical OCT and extended ophthalmoscopy usage alongside injections supports a care model that includes in-office imaging and disease monitoring.
Medicaid competitive standing is modest statewide: 92014 is ranked #272 of 413 in-state (34th percentile) and 67028 is #24 of 30 (21st percentile), both described as "typical, unremarkable volume" or lower. These in-state ranks show the provider is not a leading Medicaid participant in Wisconsin and that Medicaid contributes only a tiny share of public-payer activity.
Presence of low-frequency but higher-paid surgical retinal codes indicates some surgical capability: 67108 ($11.6K, 1.3% of Medicare revenue) and 67041 ($11.2K, 1.2% of Medicare revenue) each appear in the Medicare file with small claim counts and rank at the low end of their national provider pools (both listed with a 0th percentile label). While these procedures are a minor part of revenue, their occurrence suggests the clinician either performs or bills for occasional surgical retinal interventions in addition to office-based retina care.
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 | 420 | $690 | $288.3K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 6,600 | $30 | $191.5K |
| 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… | 990 | $110 | $105.6K |
| J2778 | Injection, ranibizumab, 0.1 mg | 520 | $180 | $94.3K |
| 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. | 730 | $100 | $73.4K |
| 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. | 1,170 | $40 | $41.1K |
| 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… | 200 | $80 | $16.2K |
| 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… | 100 | $120 | $12.1K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 10 | $1,060 | $11.6K |
| 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… | 10 | $1,020 | $11.2K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 33 | 60 | 440 | $690 | $488.1K |
| J2777 | 15 | 30 | 7,290 | $30 | $332K |
| J2778 | 4 | 10 | 520 | $180 | $131.2K |
| 67028 | 27 | 110 | 310 | $80 | $43.7K |
| J7999 | 3 | 10 | 40 | $230 | $20.2K |
| 67041 | 14 | 20 | 20 | $960 | $20.2K |
| 67108 | 13 | 10 | 20 | $960 | $17.3K |
| J9035 | 37 | 70 | 110 | $50 | $14.5K |
| 92014 | 5 | 720 | 120 | $70 | $12.9K |
| 99214 | 8,154 | 9,800 | 80 | $70 | $9.2K |
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.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 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… | 80 | $30 | $2K |
| 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. | 50 | $30 | $1.3K |
| 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. | 80 | $10 | $660 |
| 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… | 30 | $1 | $140 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 24 | 30 | 1,140 | $60 | $116.9K |
| 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… | 272 | 410 | 210 | $30 | $40.3K |
| 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. | 37 | 50 | 410 | $10 | $20.9K |
| 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… | 6 | 10 | 50 | $1 | $890 |
Other providers in the same ZIP code as Cindy Calderon, ranked by combined Medicare and Medicaid revenue.
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