Active NPI 1396804290 Individual Practitioner Male Practitioner

Dr. Brian L Heffelfinger , MD

Ophthalmology • St. Charles, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Brian Heffelfinger, MD is a certified Ophthalmology practicing in St. Charles, IL. With approximately 31 years of clinical experience since graduating from Rush Medical College Of Rush University in 1995, Dr. Heffelfinger delivers high-quality medical care to the local community at 40W330 LAFOX ROAD.

Dr. Heffelfinger is affiliated with Fox Valley Ophthalmology and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient complete exam of visual system, imaging of retina, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

40w330 Lafox Road

St. Charles, IL 60175

Telephone 6305849850

Fax 6305841523

Associated Practice Facility / Clinic

🏢 Fox Valley Ophthalmology Facility NPI 1518027994

Medicare Profile & Education

Medical School

Rush Medical College Of Rush University

Graduation Year

1995

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in St. Charles, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

31 Yrs +6.0 yrs vs City Avg

City Avg: 25.0 Yrs

State Avg: 31.1 Yrs

Regional Practice Density

6 Specialists

Practicing in St. Charles, IL (954 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

40.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Heffelfinger (31 Years) 31 Yrs

St. Charles Specialty Average (25.0 Years) 25.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	887	847	$194.62	$129.87
92134 Imaging of retina	668	638	$62.64	$41.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	583	318	$200.54	$133.64
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	464	322	$25.47	$16.99
92083 Exam of visual field with extended testing	407	363	$98.67	$65.86
92250 Photography of the retina	323	301	$57.65	$35.69
92133 Imaging of optic nerve	316	303	$56.61	$37.31
92136 Measurement of corneal curvature and depth of eye	274	116	$52.54	$26.10
99213 Established patient office or other outpatient visit, typically 15 minutes	208	186	$142.20	$94.89
66984 Removal of cataract with insertion of lens	179	101	$1121.15	$560.01
92004 New patient complete exam of visual system	106	106	$229.83	$153.31
66821 Removal of recurring cataract in lens capsule using a laser	52	41	$529.89	$353.61
92020 Examination of cornea and iris using lens device and slit lamp	45	42	$42.18	$28.19
76514 Ultrasound scan of cornea to determine thickness	38	38	$17.96	$11.23
92201 Extended exam of the back part of the eye with retinal drawing	19	19	$38.32	$25.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$263.45	$167.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	1,049	991	$198.34	$131.93
92134 Imaging of retina	763	723	$63.65	$42.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	531	333	$201.75	$134.68
92083 Exam of visual field with extended testing	447	381	$98.92	$65.93
92136 Measurement of corneal curvature and depth of eye	244	100	$53.46	$26.51
92133 Imaging of optic nerve	231	223	$57.92	$38.01
99213 Established patient office or other outpatient visit, typically 15 minutes	170	158	$142.74	$94.68
66984 Removal of cataract with insertion of lens	148	84	$1136.18	$564.26
92004 New patient complete exam of visual system	126	126	$234.36	$156.69
92250 Photography of the retina	84	81	$59.03	$36.53
92020 Examination of cornea and iris using lens device and slit lamp	57	55	$43.24	$28.93
66821 Removal of recurring cataract in lens capsule using a laser	52	43	$532.39	$346.50
76514 Ultrasound scan of cornea to determine thickness	37	37	$18.37	$11.11
92201 Extended exam of the back part of the eye with retinal drawing	18	18	$38.55	$25.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	989	934	$201.54	$134.39
92134 Imaging of retina	628	602	$64.76	$42.86
92083 Exam of visual field with extended testing	439	368	$100.44	$66.96
99213 Established patient office or other outpatient visit, typically 15 minutes	383	289	$145.47	$96.82
66984 Removal of cataract with insertion of lens	312	84	$441.10	$257.62
92133 Imaging of optic nerve	269	256	$58.83	$38.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	265	193	$203.90	$136.25
92136 Measurement of corneal curvature and depth of eye	235	97	$46.25	$27.90
92004 New patient complete exam of visual system	91	91	$237.87	$159.03
92020 Examination of cornea and iris using lens device and slit lamp	62	61	$44.36	$29.70
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	42	$91.08	$60.81
92012 Established patient problem focused exam of visual system	44	42	$142.68	$95.48
66821 Removal of recurring cataract in lens capsule using a laser	32	24	$566.63	$378.84
76514 Ultrasound scan of cornea to determine thickness	24	24	$18.80	$11.32
65855 Laser repair to improve eye fluid flow	23	16	$398.06	$262.78
92201 Extended exam of the back part of the eye with retinal drawing	12	12	$38.99	$26.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	692	471	$145.98	$97.82
92014 Established patient complete exam of visual system	670	646	$209.58	$135.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	592	530	$214.51	$139.01
92134 Imaging of retina	538	516	$90.91	$43.85
92133 Imaging of optic nerve	490	474	$93.44	$39.71
92083 Exam of visual field with extended testing	457	386	$224.29	$68.05
66984 Removal of cataract with insertion of lens	413	97	$535.43	$224.89
92136 Measurement of corneal curvature and depth of eye	269	110	$46.78	$30.22
92004 New patient complete exam of visual system	104	104	$260.68	$160.76
92020 Examination of cornea and iris using lens device and slit lamp	100	93	$48.63	$29.76
92012 Established patient problem focused exam of visual system	62	60	$152.48	$95.90
76514 Ultrasound scan of cornea to determine thickness	62	62	$66.86	$11.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$269.97	$180.41
66821 Removal of recurring cataract in lens capsule using a laser	48	39	$1122.66	$365.76
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	41	$114.33	$60.48
92201 Extended exam of the back part of the eye with retinal drawing	40	38	$66.97	$26.47
68761 Closure of tear duct opening using plug	29	15	$247.16	$126.11
66761 Creation of eye fluid drainage tracts in iris using a laser, per session	22	13	$771.30	$326.61
65855 Laser repair to improve eye fluid flow	17	13	$776.20	$262.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	13	$310.92	$194.69
92250 Photography of the retina	13	13	$129.84	$42.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$180.00	$120.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	872	851	$215.00	$117.02
99213 Established patient office or other outpatient visit, typically 15 minutes	678	462	$146.00	$80.68
92134 Imaging of retina	451	435	$100.00	$43.58
92133 Imaging of optic nerve	372	367	$100.00	$39.92
92083 Exam of visual field with extended testing	355	319	$250.00	$67.88
66984 Removal of cataract with insertion of lens	303	86	$756.44	$271.39
92136 Measurement of corneal curvature and depth of eye	222	93	$48.04	$33.53
92014 Established patient complete exam of visual system	95	94	$215.00	$133.87
92012 Established patient problem focused exam of visual system	94	87	$167.00	$94.76
92020 Examination of cornea and iris using lens device and slit lamp	89	85	$50.56	$29.26
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$270.00	$177.47
92004 New patient complete exam of visual system	42	42	$270.00	$156.90
92201 Extended exam of the back part of the eye with retinal drawing	39	38	$75.00	$26.94
66821 Removal of recurring cataract in lens capsule using a laser	39	28	$1200.00	$361.08
76514 Ultrasound scan of cornea to determine thickness	34	34	$75.00	$12.45
68761 Closure of tear duct opening using plug	32	16	$250.00	$119.29
65855 Laser repair to improve eye fluid flow	29	25	$800.00	$259.04
66761 Creation of eye fluid drainage tracts in iris using a laser, per session	19	11	$800.00	$326.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$180.00	$116.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,056	1,026	$215.00	$115.14
99213 Established patient office or other outpatient visit, typically 15 minutes	819	493	$145.29	$78.74
66984 Removal of cataract with insertion of lens	696	148	$573.56	$240.29
92134 Imaging of retina	484	459	$100.00	$43.35
92133 Imaging of optic nerve	461	449	$100.00	$39.19
92083 Exam of visual field with extended testing	447	396	$250.00	$68.06
92136 Measurement of corneal curvature and depth of eye	382	163	$46.39	$35.98
92012 Established patient problem focused exam of visual system	149	134	$166.89	$93.24
92020 Examination of cornea and iris using lens device and slit lamp	96	92	$54.69	$28.61
92014 Established patient complete exam of visual system	91	89	$215.00	$129.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	63	63	$270.00	$175.56
92004 New patient complete exam of visual system	62	62	$270.00	$159.95
66821 Removal of recurring cataract in lens capsule using a laser	60	48	$1113.33	$356.24
65855 Laser repair to improve eye fluid flow	37	26	$800.00	$263.64
92225 Examination of eye by ophthalmoscope with retinal drawing	36	36	$82.64	$36.44
76514 Ultrasound scan of cornea to determine thickness	34	34	$71.32	$13.07
68761 Closure of tear duct opening using plug	24	12	$250.00	$114.98
66761 Creation of eye fluid drainage tracts in iris using a laser, per session	23	13	$800.00	$321.49
92002 New patient problem focused exam of visual system	11	11	$188.00	$89.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$177.64	$108.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	865	544	$146.00	$76.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	844	828	$215.00	$112.55
66984 Removal of cataract with insertion of lens	739	144	$509.88	$211.97
92133 Imaging of optic nerve	447	441	$100.00	$39.47
92083 Exam of visual field with extended testing	443	398	$250.00	$67.35
92136 Measurement of corneal curvature and depth of eye	399	164	$47.03	$39.24
92134 Imaging of retina	319	311	$100.00	$43.52
92014 Established patient complete exam of visual system	317	313	$215.00	$132.16
92012 Established patient problem focused exam of visual system	136	123	$167.00	$91.61
92004 New patient complete exam of visual system	116	116	$236.29	$158.30
92020 Examination of cornea and iris using lens device and slit lamp	116	109	$75.00	$27.64
92225 Examination of eye by ophthalmoscope with retinal drawing	54	52	$86.11	$32.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$236.00	$174.21
66821 Removal of recurring cataract in lens capsule using a laser	39	33	$800.00	$350.17
76514 Ultrasound scan of cornea to determine thickness	26	26	$50.00	$15.57
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$167.00	$114.98
66982 Complex removal of cataract with insertion of prosthetic lens	14	11	$2000.00	$842.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$125.00	$46.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,011	126	$346.79	$140.64
99213 Established patient office or other outpatient visit, typically 15 minutes	830	527	$146.00	$76.19
92014 Established patient complete exam of visual system	566	555	$215.00	$128.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	552	539	$215.00	$112.16
92083 Exam of visual field with extended testing	444	407	$250.00	$67.13
92133 Imaging of optic nerve	443	436	$100.00	$39.05
92136 Measurement of corneal curvature and depth of eye	351	137	$45.90	$42.79
92134 Imaging of retina	263	252	$100.00	$42.73
92004 New patient complete exam of visual system	152	152	$236.00	$155.63
92012 Established patient problem focused exam of visual system	138	128	$167.00	$87.93
92020 Examination of cornea and iris using lens device and slit lamp	109	107	$75.00	$27.27
66982 Complex removal of cataract with insertion of prosthetic lens	102	11	$315.69	$131.34
66821 Removal of recurring cataract in lens capsule using a laser	60	46	$800.00	$345.16
92225 Examination of eye by ophthalmoscope with retinal drawing	55	54	$88.64	$30.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$167.00	$114.74
66761 Creation of eye fluid drainage tracts in iris using a laser, per session	25	13	$1200.00	$311.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	23	$125.00	$45.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$236.00	$173.74
76514 Ultrasound scan of cornea to determine thickness	20	20	$50.00	$14.56

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

36097684 (IL)

Commercial Insurance / Payer ID Bcbs

4519570 (IL)

Commercial Insurance / Payer ID United Healthcare

2032261 (IL)

Hospital & Practice Group Affiliations

Fox Valley Ophthalmology

40 W330 Lafox Rd, Saint Charles, IL 601756515

Phone: 6305849850

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Dr. Maria Pica , OD

Optometrist

NPI 1003975913

Doctor of Optometry

Dr. Eric Quartetti , MD

Ophthalmology

NPI 1104985159

Doctor of Medicine (M.D.)

Dr. Alexandria Halkias , OD

Optometrist

NPI 1336208016

Doctor of Optometry

Dr. Christy Harvey , MD

Ophthalmology

NPI 1417390584

Doctor of Medicine (M.D.)

Dr. Lucas Wendel , MD

Ophthalmology

NPI 1427256601

Doctor of Medicine (M.D.)

Dr. Alan Hefner , MD

Ophthalmology

NPI 1962561282

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active March 27, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location March 27, 2008

Registered at 40W330 LAFOX ROAD, ST. CHARLES, IL 60175 (Tel: 6305849850)

📍

Updated Business Mailing Address March 27, 2008

Registered at 40W330 LAFOX ROAD, ST. CHARLES, IL 60175 (Tel: 6305849850)

👤

Provider Name / Credentials Updated March 27, 2008

Recorded as BRIAN HEFFELFINGER, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 27, 2008

Ophthalmology

🟢

Initial NPI Registration & Enumeration December 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396804290

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 06, 2006

Last Update: March 27, 2008

Sole Proprietor: No

Update or Correct Profile

Mailing Address

40w330 Lafox Road

St. Charles, IL 60175

Phone: 6305849850

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.