Active NPI 1164456943 Individual Practitioner Male Practitioner

Dr. Raul Adrian Pena , MD

Ophthalmology • Mcallen, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Raul Pena, MD is a certified Ophthalmology practicing in Mcallen, TX. With approximately 38 years of clinical experience since completing medical education in 1988, Dr. Pena delivers high-quality medical care to the local community at 1400 E RIDGE RD STE 10.

Dr. Pena is affiliated with Raul Adrian Pena Md Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include removal of cataract with insertion of lens, established patient problem focused exam of visual system, removal of recurring cataract in lens capsule using a laser. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1400 E Ridge Rd Ste 10

Mcallen, TX 785031536

Telephone 9566618733

Fax 9566618724

Associated Practice Facility / Clinic

🏢 Raul Adrian Pena Md Pa Facility NPI 1407037633

Medicare Profile & Education

Medical School

Other

Graduation Year

1988

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Mcallen, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

38 Yrs +7.9 yrs vs City Avg

City Avg: 30.1 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

18 Specialists

Practicing in Mcallen, TX (1616 Statewide)

Telehealth Adoption Rate

5.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

71.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Pena (38 Years) 38 Yrs

Mcallen Specialty Average (30.1 Years) 30.1 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
66984 Removal of cataract with insertion of lens	205	115	$2500.00	$528.98
92012 Established patient problem focused exam of visual system	148	123	$106.00	$88.83
66821 Removal of recurring cataract in lens capsule using a laser	135	80	$1200.00	$333.69
92136 Measurement of corneal curvature and depth of eye	133	91	$100.00	$36.50
92025 Ct scan of cornea	62	62	$300.00	$33.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$250.00	$169.03
92014 Established patient complete exam of visual system	50	48	$166.00	$125.54
92286 Imaging of front third of eye using a special microscope	33	32	$200.00	$39.15
92134 Imaging of retina	18	18	$200.00	$37.65
66982 Complex removal of cataract with insertion of prosthetic lens	15	13	$2500.00	$720.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	180	153	$106.00	$86.66
66821 Removal of recurring cataract in lens capsule using a laser	163	93	$1200.00	$323.27
66984 Removal of cataract with insertion of lens	148	83	$2500.00	$495.27
92136 Measurement of corneal curvature and depth of eye	144	74	$100.00	$41.84
92014 Established patient complete exam of visual system	74	71	$166.00	$120.66
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$250.00	$162.24
92025 Ct scan of cornea	49	49	$300.00	$32.44
92286 Imaging of front third of eye using a special microscope	45	43	$200.00	$37.98
67031 Laser release of scar tissue between the lens and retina	25	15	$1200.00	$376.40
92134 Imaging of retina	23	20	$200.00	$38.16
92083 Exam of visual field with extended testing	19	19	$200.00	$60.72
92133 Imaging of optic nerve	19	19	$200.00	$33.22
92250 Photography of the retina	18	18	$300.00	$36.01
66982 Complex removal of cataract with insertion of prosthetic lens	18	13	$2500.00	$678.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	276	214	$106.00	$87.57
92136 Measurement of corneal curvature and depth of eye	211	104	$100.00	$46.90
66984 Removal of cataract with insertion of lens	178	99	$2500.00	$496.79
66821 Removal of recurring cataract in lens capsule using a laser	157	88	$1200.00	$319.36
92014 Established patient complete exam of visual system	122	118	$166.00	$121.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	105	105	$250.00	$161.13
92286 Imaging of front third of eye using a special microscope	44	43	$200.00	$35.22
92133 Imaging of optic nerve	22	22	$200.00	$34.04
67031 Laser release of scar tissue between the lens and retina	20	12	$1200.00	$379.19
92134 Imaging of retina	20	19	$200.00	$39.47
92083 Exam of visual field with extended testing	19	19	$200.00	$61.48
92250 Photography of the retina	18	18	$300.00	$36.61
66982 Complex removal of cataract with insertion of prosthetic lens	14	11	$2500.00	$671.12
92025 Ct scan of cornea	13	13	$300.00	$32.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	315	233	$106.00	$87.63
92136 Measurement of corneal curvature and depth of eye	268	135	$100.00	$51.16
66984 Removal of cataract with insertion of lens	219	121	$2500.00	$510.10
92014 Established patient complete exam of visual system	180	169	$166.00	$123.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	162	162	$250.00	$163.82
66821 Removal of recurring cataract in lens capsule using a laser	152	84	$1200.00	$323.24
92286 Imaging of front third of eye using a special microscope	74	74	$200.00	$35.14
92083 Exam of visual field with extended testing	40	39	$200.00	$62.02
92133 Imaging of optic nerve	37	37	$200.00	$33.73
92250 Photography of the retina	24	24	$300.00	$38.47
66982 Complex removal of cataract with insertion of prosthetic lens	17	12	$2500.00	$725.99
92134 Imaging of retina	16	16	$200.00	$40.21
68761 Closure of tear duct opening using plug	13	13	$150.00	$147.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	309	225	$106.00	$86.69
92136 Measurement of corneal curvature and depth of eye	232	131	$100.00	$50.66
66984 Removal of cataract with insertion of lens	229	130	$2500.00	$518.68
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	171	171	$250.00	$159.11
92014 Established patient complete exam of visual system	162	156	$166.00	$123.65
66821 Removal of recurring cataract in lens capsule using a laser	155	85	$1200.00	$325.58
92286 Imaging of front third of eye using a special microscope	65	65	$200.00	$34.23
92083 Exam of visual field with extended testing	49	49	$200.00	$60.82
92133 Imaging of optic nerve	47	47	$200.00	$33.59
0191T Internal insertion of eye fluid drainage device	26	15	$2500.00	$328.63
95930 Measurement of nerve conduction using visual stimulation testing with report	22	22	$300.00	$65.34
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	21	21	$200.00	$127.93
92250 Photography of the retina	19	18	$300.00	$44.35
66982 Complex removal of cataract with insertion of prosthetic lens	18	17	$2500.00	$719.62
67031 Laser release of scar tissue between the lens and retina	17	12	$1305.88	$387.37
92134 Imaging of retina	12	11	$200.00	$40.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92136 Measurement of corneal curvature and depth of eye	532	182	$67.29	$33.29
92012 Established patient problem focused exam of visual system	495	342	$106.00	$85.42
66984 Removal of cataract with insertion of lens	297	166	$2500.00	$604.64
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	281	281	$250.00	$160.06
92014 Established patient complete exam of visual system	242	231	$166.00	$121.81
66821 Removal of recurring cataract in lens capsule using a laser	204	116	$1200.00	$324.06
92286 Imaging of front third of eye using a special microscope	109	109	$200.00	$34.73
92083 Exam of visual field with extended testing	82	82	$200.00	$62.07
92133 Imaging of optic nerve	79	78	$200.00	$33.68
92250 Photography of the retina	41	41	$300.00	$47.82
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	37	37	$205.41	$128.92
95930 Measurement of nerve conduction using visual stimulation testing with report	37	37	$300.00	$66.11
92134 Imaging of retina	34	28	$200.00	$39.95
0191T Internal insertion of eye fluid drainage device	33	19	$2500.00	$323.71
0376T Insertion of eye drainage device	32	19	$2500.00	$166.62
66982 Complex removal of cataract with insertion of prosthetic lens	29	24	$2500.00	$759.96
65855 Laser repair to improve eye fluid flow	17	11	$1500.00	$242.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	593	421	$106.00	$83.88
92136 Measurement of corneal curvature and depth of eye	359	203	$105.15	$54.66
66984 Removal of cataract with insertion of lens	338	190	$2500.00	$596.48
66821 Removal of recurring cataract in lens capsule using a laser	305	175	$1200.00	$317.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	281	281	$250.00	$159.16
92014 Established patient complete exam of visual system	276	267	$166.00	$121.40
92286 Imaging of front third of eye using a special microscope	137	137	$200.00	$33.96
92083 Exam of visual field with extended testing	101	100	$200.00	$60.96
92133 Imaging of optic nerve	93	93	$200.00	$33.48
92275 Recording of retinal electrical responses to external stimuli	52	51	$300.00	$143.35
95930 Measurement of nerve conduction using visual stimulation testing with report	51	50	$300.00	$66.51
92134 Imaging of retina	48	36	$200.00	$39.99
0191T Internal insertion of eye fluid drainage device	44	24	$2500.00	$796.11
66982 Complex removal of cataract with insertion of prosthetic lens	28	24	$2500.00	$739.94
65855 Laser repair to improve eye fluid flow	26	14	$1500.00	$238.07
92250 Photography of the retina	18	18	$300.00	$54.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	692	445	$106.00	$81.38
66984 Removal of cataract with insertion of lens	380	215	$2500.00	$588.84
92136 Measurement of corneal curvature and depth of eye	304	209	$140.79	$72.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	299	299	$250.00	$157.04
66821 Removal of recurring cataract in lens capsule using a laser	279	162	$1200.00	$313.34
92014 Established patient complete exam of visual system	258	246	$166.00	$118.13
92286 Imaging of front third of eye using a special microscope	118	117	$200.00	$33.78
92083 Exam of visual field with extended testing	105	105	$200.00	$60.92
92133 Imaging of optic nerve	99	99	$200.00	$33.35
92134 Imaging of retina	49	34	$200.00	$38.94
0191T Internal insertion of eye fluid drainage device	43	23	$2500.00	$991.55
92275 Recording of retinal electrical responses to external stimuli	30	30	$300.00	$140.19
95930 Measurement of nerve conduction using visual stimulation testing with report	30	30	$300.00	$120.83
65855 Laser repair to improve eye fluid flow	29	17	$1500.00	$233.67
92025 Ct scan of cornea	17	17	$300.00	$34.19
66982 Complex removal of cataract with insertion of prosthetic lens	16	15	$2500.00	$735.26
92250 Photography of the retina	11	11	$300.00	$59.81

Medical Specialties & State Licenses

CMS Verified: 2020-05-05

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License TX L0504

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

Commercial Insurance / Payer ID Medical License

L0504 (TX)

Hospital & Practice Group Affiliations

Raul Adrian Pena Md Pa

1400 E Ridge Rd, Mcallen, TX 785031536

Phone: 9566618733

Practice Associates & Co-Workers

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

5 Associated Practitioners

Dr. Armando Reyes , OD

Optometrist

NPI 1235275017

Doctor of Optometry

Dr. Sandra Flores , OD

Optometrist

NPI 1437206208

Doctor of Optometry

Dr. Victoria Gutierrez , OD

Optometrist

NPI 1467201947

Doctor of Optometry

Dr. Mayra Lopez , OD

Optometrist

NPI 1922472380

Doctor of Optometry

Dr. Aurelio Tijerina , OD

Optometrist

NPI 1972230456

Doctor of Optometry

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active November 19, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location November 19, 2007

Registered at 1400 E RIDGE RD STE 10, MCALLEN, TX 785031536 (Tel: 9566618733)

📍

Updated Business Mailing Address November 19, 2007

Registered at 1400 E RIDGE RD STE 10, MCALLEN, TX 785031536 (Tel: 9566618733)

👤

Provider Name / Credentials Updated November 19, 2007

Recorded as RAUL PENA, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 19, 2007

Ophthalmology (License #L0504 in TX)

🟢

Initial NPI Registration & Enumeration July 10, 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: 1164456943

Entity Type:

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

Enumeration Date: July 10, 2006

Last Update: May 05, 2020

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1400 E Ridge Rd Ste 10

Mcallen, TX 785031536

Phone: 9566618733

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.