Ophthalmology Compensation Rates for Private Equity

(Updated 10/9/19) Ophthalmology Compensation Rates for Private Equity is a 12-month subscription that is updated annually.  This compensation system is based on the billing patterns of over 16,000 U.S. ophthalmologists and 26,000 U.S.optometrists.  The system covers both generalists and sub-specialties with adjustments for 112 U.S. geographic practice cost indices, as well as blended and separate rates for office-based and facility-based sites of service.

Ophththalmology Compensation Rates for Private Equity represent normalized compensation-to-collection rates that may be applied to any payor mix.  Compensation-to-collection rates are commonly used for:

  • Employed professional compensation-to-collection rates (read more)
  • Locum tenens compensation-to-collections rates (read more)
  • Ophthalmology co-management arrangements.  The 80/20 ratio published by CMS may be applied to the compensation-to-collection rates in this compensation system to adjudicate payments between surgeons and other non-surgical eye care providers.

The rates are calculated using the latest Medicare utilization data and compensation ratios published by the RVS Update Committee.  Rates will be automatically adjusted for new utilization data each year when Medicare releases it (The 2021 proposed rule adjustments will be available 9-18-20).

Summary tables are provided identifying 5th, 50th, and 95th percentiles rates using RVS Update Committee data, as well as adjustments for all 112 Geographic Practice Cost Indices (GPCIs), and sites of service (office-based, facility-based, total combined).

Beginning with Version 1.2, all the personally-performed professional components of Stark DHS are included for all specialties.

Visual Illustration: 3 of 112 Markets
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Note: Proportionately higher compensation-to-collection rates at the 95th Percentile are attributable to a small number of ophthalmologists who perform large volumes of procedures in facility (non-office-based) settings.  The 95th percentile rates are not appropriate for most ophthalmologists, unless you maintain a provider-based practice in a hospital or nursing facility where you regularly perform all of your extended ophthalmoscopy, intravitreal injections, and sensory motor testing.

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Important Disclaimers:

This compensation system, and the underlying data sets on which it is based, do not constitute a survey.  The summaries, calculations, and raw data provided are predicated on a large sample of Medicare utilization data that is updated annually.  HCTadvisor makes no representations as to whether this large sample is representative of the total utilization for any individual provider or any provider specialty as a whole.

Source Data Sample Sizes (n=43,714):
wdt_ID Medicare 855i Primary Specialty NPI Self Identified Primary Specialty Sample (n)
95 Ophthalmology Ophthalmology 15,579
96 Ophthalmology Ophthalmology - Glaucoma Specialist 43
97 Ophthalmology Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery 152
98 Ophthalmology Ophthalmology - Retina Specialist 343
99 Optometry Eye and Vision Services Providers - Optometrist 26,660
100 Optometry Eye and Vision Services Providers - Optometrist - Corneal and Contact Management 701
101 Optometry Eye and Vision Services Providers - Optometrist - Low Vision Rehabilitation 106
102 Optometry Eye and Vision Services Providers - Optometrist - Vision Therapy 130