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NPI 1932100799 · Metairie, LA · Ophthalmology Physician
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Robert Ross is a ophthalmology physician provider located in Metairie, Louisiana. This profile covers 23 Medicare and 5 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 | Robert Ross |
| Address | 4224 Houma Blvd |
| City | Metairie |
| State | LA |
| ZIP | 70006 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | August 2, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.4M |
| Medicaid | $3.7K |
The provider’s Medicare billing is concentrated in retina-focused therapies and diagnostic imaging: J2777 ($548.1K, 38.0% of Medicare revenue) and J0178 ($248.6K, 17.3%) are the two largest drug/injection drivers, while 92014 ($149.5K, 10.4%) is the top office-exam code. Together these codes point to an operation built around intravitreal biologic injections and high-volume retinal evaluation rather than a general ophthalmology mix.
Medicare revenue concentration is high: the top three Medicare codes account for 65.7% of this provider’s total Medicare revenue, driven by J2777, J0178, and 92014. This level of concentration indicates the practice’s financial exposure is closely tied to a small set of retina/injection and comprehensive exam services.
On Medicaid the revenue base is very small relative to Medicare — total Medicaid revenue is $3.7K versus total Medicare revenue of $1.4M — and is heavily concentrated: the top three Medicaid codes account for 84.9% of Medicaid revenue. The Medicaid top codes are dominated by 92014 ($1.7K, 46.4%), 92134 ($918, 24.8%), and 92250 ($507, 13.7%), underscoring that even Medicaid activity mirrors the Medicare service mix but at a much lower scale.
The provider’s competitive footprint differs by code: 92014 is an extreme outlier nationally (ranks #435 of 35415 providers, 99th percentile), and 92250 is also reported as an extreme outlier (ranks #111 of 25087 providers, 100th percentile), indicating unusually high volumes of comprehensive established exams and fundus photography relative to peers. By contrast, J2777 ranks #569 of 2039 (72th percentile; typical, unremarkable volume) and J0178 ranks #2185 of 3204 (32th percentile; typical, unremarkable volume), suggesting the provider’s injection volumes are not nationally dominant despite large absolute revenue from J2777.
Procedure-level mix shows different reimbursement dynamics: J2777 has very high claim count (18.9K claims) with a low average paid/claim ($29) producing $548.1K revenue, whereas J0178 has far fewer claims (370) but a much higher average paid/claim ($672) producing $248.6K. This pattern indicates reliance on a high-volume, low-unit-payment biologic (J2777) supplemented by lower-volume, higher-unit-payment injectables (J0178), which has implications for drug sourcing, inventory, and per-claim reimbursement sensitivity.
Imaging and diagnostic services form a substantial secondary revenue stream: 92134 ($46.1K, 3.2% of Medicare revenue) is notably above typical national volume (95th percentile), and other imaging/angiography codes such as 92235 and 92240 are at notably above-typical or typical percentiles. This mix supports a practice workflow that couples injection visits with retinal imaging and angiography, reinforcing a retina-specialty service line.
Medicaid competitive standing is modest within the state: the provider’s top Medicaid codes rank low in-state (92014 at #590 of 655, 10th percentile; 92134 at #111 of 133, 17th percentile; 92250 at #202 of 211, 2th percentile), indicating limited Medicaid volume and footprint compared with Louisiana peers. The small absolute Medicaid revenue ($3.7K) and low in-state ranks suggest Medicaid is not a material payer for this provider’s business.
The provider’s NPI tenure indicates an established practice presence: enumerated on 2005-08-02 (~21 years ago), the provider has a long billing history that aligns with sustained Medicare activity and the high-volume exam and imaging outlier status observed in multiple codes. Long tenure combined with concentrated revenue streams suggests an entrenched retina-focused practice rather than recent episodic billing activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 18,900 | $30 | $548.1K |
| J0178 | Injection, aflibercept, 1 mg | 370 | $670 | $248.6K |
| 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… | 1,680 | $90 | $149.5K |
| J3590 | Unclassified biologics | 70 | $2,150 | $143.8K |
| 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. | 710 | $80 | $58.5K |
| 92240 | The provider uses a special dye, indocyanine–green (ICG), to take photographs of the vessels of the inner eye similar to that done for codes 92230/92235, which use fluorescein dye. He interprets the… | 350 | $130 | $46.7K |
| 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. | 1,650 | $30 | $46.1K |
| 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… | 490 | $90 | $45.6K |
| J3490 | Unclassified drugs | 20 | $2,330 | $37.3K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 1,310 | $30 | $35.3K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 23 | 50 | 300 | $680 | $371.5K |
| J2777 | 5 | 30 | 6,660 | $30 | $309.4K |
| J3590 | 3 | 10 | 70 | $490 | $92K |
| J3490 | 16 | 20 | 50 | $620 | $49.1K |
| 67028 | 17 | 70 | 410 | $80 | $44.3K |
| 92240 | 1 | 10 | 230 | $130 | $29.9K |
| 92014 | 7 | 470 | 170 | $80 | $23.9K |
| 93886 | 16 | 20 | 40 | $170 | $18.9K |
| 67210 | 2 | 10 | 40 | $380 | $16.5K |
| 92012 | 172 | 350 | 100 | $60 | $11.7K |
Showing 1–10 of 23
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.
5 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 | $50 | $1.7K |
| 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. | 50 | $20 | $920 |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 10 | $40 | $510 |
| 92201 | 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… | 20 | $20 | $320 |
| 92226 | N/A | 20 | $10 | $240 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
5 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… | 590 | 660 | 1,070 | $60 | $129.3K |
| 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. | 111 | 130 | 490 | $10 | $19.4K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 202 | 210 | 200 | $20 | $17.5K |
| 92201 | 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… | 17 | 20 | 110 | $10 | $7.7K |
| 92226 | N/A | 29 | 30 | 450 | $10 | $5.5K |
Other providers in the same ZIP code as Robert Ross, ranked by combined Medicare and Medicaid revenue.
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