Active NPI 1144300542 Individual Practitioner Male Practitioner

Dr. Samuel K Seto , MD

Ophthalmology • Edmonds, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Seto, MD is a certified Ophthalmology practicing in Edmonds, WA. With approximately 35 years of clinical experience since graduating from University Of Wisconsin School Of Medicine in 1991, Dr. Seto delivers high-quality medical care to the local community at 21911 76TH AVE W.

Dr. Seto is affiliated with Samuel K. Seto Md Pllc and accepts Medicare assignment.

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

Practice Location & Contact Primary Location

Practice Address

21911 76th Ave W
Suite 101

Edmonds, WA 980267903

Telephone 4257747723

Fax 4257782788

Associated Practice Facility / Clinic

🏢 Samuel K. Seto Md Pllc Facility NPI 1497827711

Medicare Profile & Education

Medical School

University Of Wisconsin School Of Medicine

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Edmonds, WA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

35 Yrs +6.0 yrs vs City Avg

City Avg: 29.0 Yrs

State Avg: 26.4 Yrs

Regional Practice Density

10 Specialists

Practicing in Edmonds, WA (552 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

58.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Seto (35 Years) 35 Yrs

Edmonds Specialty Average (29.0 Years) 29.0 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	464	321	$185.65	$127.32
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	440	299	$20.00	$16.15
99213 Established patient office or other outpatient visit, typically 15 minutes	249	141	$134.98	$90.66
92250 Photography of the retina	144	141	$120.00	$36.96
92134 Imaging of retina	99	90	$80.00	$39.42
92083 Exam of visual field with extended testing	91	85	$150.00	$63.44
92133 Imaging of optic nerve	85	80	$80.00	$36.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	83	83	$287.59	$166.31
92136 Measurement of corneal curvature and depth of eye	58	36	$112.07	$40.19
66984 Removal of cataract with insertion of lens	38	26	$1800.00	$539.83
92025 Ct scan of cornea	36	33	$150.00	$34.80
92014 Established patient complete exam of visual system	29	27	$164.14	$125.66
66821 Removal of recurring cataract in lens capsule using a laser	28	21	$700.00	$333.91
76514 Ultrasound scan of cornea to determine thickness	14	14	$75.00	$10.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$183.33	$111.09

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	471	336	$170.00	$128.24
99213 Established patient office or other outpatient visit, typically 15 minutes	221	128	$120.00	$90.96
92250 Photography of the retina	170	163	$120.00	$37.93
92134 Imaging of retina	133	124	$80.00	$39.83
92014 Established patient complete exam of visual system	112	96	$160.00	$128.22
92083 Exam of visual field with extended testing	93	89	$150.00	$63.47
92133 Imaging of optic nerve	85	81	$80.00	$36.93
92136 Measurement of corneal curvature and depth of eye	78	53	$114.10	$42.48
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	77	77	$270.00	$167.22
66984 Removal of cataract with insertion of lens	63	39	$1800.00	$571.27
92025 Ct scan of cornea	47	47	$150.00	$36.59
66821 Removal of recurring cataract in lens capsule using a laser	46	35	$700.00	$330.38
76514 Ultrasound scan of cornea to determine thickness	15	15	$75.00	$11.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$170.00	$112.68

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	556	348	$170.36	$129.29
99213 Established patient office or other outpatient visit, typically 15 minutes	209	123	$120.00	$91.63
92250 Photography of the retina	179	173	$120.00	$37.76
92134 Imaging of retina	115	107	$80.00	$40.09
92083 Exam of visual field with extended testing	104	99	$150.00	$64.03
92133 Imaging of optic nerve	82	81	$80.00	$37.15
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	76	76	$270.00	$168.22
92136 Measurement of corneal curvature and depth of eye	71	48	$113.80	$44.13
66984 Removal of cataract with insertion of lens	50	35	$1800.00	$543.41
92025 Ct scan of cornea	47	47	$150.00	$36.36
66821 Removal of recurring cataract in lens capsule using a laser	34	26	$700.00	$334.40
92014 Established patient complete exam of visual system	32	32	$160.00	$122.38

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	472	341	$170.00	$131.30
92250 Photography of the retina	162	158	$120.00	$40.25
92014 Established patient complete exam of visual system	158	151	$160.00	$129.58
99213 Established patient office or other outpatient visit, typically 15 minutes	131	82	$120.00	$93.08
92134 Imaging of retina	93	89	$80.00	$41.31
92133 Imaging of optic nerve	88	86	$80.00	$37.69
92083 Exam of visual field with extended testing	88	84	$150.00	$65.15
92136 Measurement of corneal curvature and depth of eye	39	30	$115.90	$49.86
66984 Removal of cataract with insertion of lens	37	24	$1800.00	$507.10
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$270.00	$170.59
66821 Removal of recurring cataract in lens capsule using a laser	31	24	$700.00	$343.52
92025 Ct scan of cornea	26	26	$143.08	$37.04
92012 Established patient problem focused exam of visual system	15	12	$100.00	$92.43
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$170.00	$114.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	629	370	$160.00	$128.93
92250 Photography of the retina	169	163	$120.00	$46.06
92083 Exam of visual field with extended testing	107	103	$150.00	$64.34
92012 Established patient problem focused exam of visual system	100	61	$100.00	$90.15
92133 Imaging of optic nerve	95	92	$80.00	$37.99
92134 Imaging of retina	71	64	$80.00	$42.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	42	38	$170.00	$111.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	26	$90.00	$45.35
92136 Measurement of corneal curvature and depth of eye	37	24	$113.51	$53.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$270.00	$168.04
66821 Removal of recurring cataract in lens capsule using a laser	28	23	$700.00	$329.97
99213 Established patient office or other outpatient visit, typically 15 minutes	22	16	$120.00	$73.11
66984 Removal of cataract with insertion of lens	16	12	$1800.00	$526.27
66982 Complex removal of cataract with insertion of prosthetic lens	16	12	$2200.00	$753.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	757	426	$160.00	$128.30
92250 Photography of the retina	224	219	$120.00	$50.95
92012 Established patient problem focused exam of visual system	166	100	$100.00	$88.91
92083 Exam of visual field with extended testing	132	127	$150.00	$65.12
92133 Imaging of optic nerve	105	103	$80.00	$37.53
92134 Imaging of retina	89	87	$80.00	$41.26
66984 Removal of cataract with insertion of lens	69	45	$1800.00	$605.51
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	$164.58
92136 Measurement of corneal curvature and depth of eye	59	49	$118.98	$68.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	35	$170.00	$107.94
66821 Removal of recurring cataract in lens capsule using a laser	28	25	$700.00	$339.23
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	25	$90.00	$45.69
92136 Measurement of corneal curvature and depth of eye	25	25	$100.00	$31.06
99213 Established patient office or other outpatient visit, typically 15 minutes	23	18	$120.00	$75.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$170.00	$109.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	786	440	$160.00	$119.74
92250 Photography of the retina	214	211	$120.00	$54.20
92083 Exam of visual field with extended testing	145	137	$150.00	$60.62
92012 Established patient problem focused exam of visual system	113	75	$100.00	$81.73
92133 Imaging of optic nerve	99	97	$80.00	$35.60
92134 Imaging of retina	82	78	$80.00	$39.26
66984 Removal of cataract with insertion of lens	46	32	$1800.00	$563.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	35	$170.00	$99.23
92136 Measurement of corneal curvature and depth of eye	43	36	$118.60	$72.16
66821 Removal of recurring cataract in lens capsule using a laser	42	36	$700.00	$315.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	40	40	$270.00	$156.26
99213 Established patient office or other outpatient visit, typically 15 minutes	18	15	$120.00	$66.76
92136 Measurement of corneal curvature and depth of eye	14	14	$100.00	$29.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	826	458	$160.02	$119.59
92250 Photography of the retina	218	208	$120.00	$63.54
92083 Exam of visual field with extended testing	160	143	$150.00	$62.50
92012 Established patient problem focused exam of visual system	139	85	$100.00	$83.00
92133 Imaging of optic nerve	120	118	$80.00	$36.18
92134 Imaging of retina	104	96	$80.00	$39.28
66984 Removal of cataract with insertion of lens	71	52	$1800.00	$571.17
92136 Measurement of corneal curvature and depth of eye	57	51	$117.54	$80.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	30	$172.78	$94.37
66821 Removal of recurring cataract in lens capsule using a laser	35	26	$700.00	$319.57
99213 Established patient office or other outpatient visit, typically 15 minutes	35	29	$120.00	$65.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$270.00	$157.66
76514 Ultrasound scan of cornea to determine thickness	21	20	$75.00	$13.84
92136 Measurement of corneal curvature and depth of eye	17	17	$100.00	$30.53
92004 New patient complete exam of visual system	15	15	$180.00	$144.21
92020 Examination of cornea and iris using lens device and slit lamp	13	12	$50.00	$26.10

Medical Specialties & State Licenses

CMS Verified: 2023-11-14

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License WA MD00032689

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

1094564 (WA)

Commercial Insurance / Payer ID Dmerc Provider Number

019394001 (WA)

Commercial Insurance / Payer ID L&i Provider Number

101465 (WA)

Commercial Insurance / Payer ID Regence Provider Number

SE5264 (WA)

Hospital & Practice Group Affiliations

Samuel K. Seto Md Pllc

21911 76th Ave W, Edmonds, WA 980267918

Phone: 4257747723

Practice Associates & Co-Workers

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

2 Associated Practitioners

Dr. Angelica Sup , OD

Optometrist

NPI 1366522633

Doctor of Optometry

Steven Seto

Ophthalmology

NPI 1861029399

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active August 17, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location August 17, 2010

Registered at 21911 76TH AVE W, SUITE 101, EDMONDS, WA 980267903 (Tel: 4257747723)

📍

Updated Business Mailing Address August 17, 2010

Registered at 21911 76TH AVE W, SUITE 101, EDMONDS, WA 980267903 (Tel: 4257747723)

👤

Provider Name / Credentials Updated August 17, 2010

Recorded as SAMUEL SETO, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 17, 2010

Ophthalmology (License #MD00032689 in WA)

🟢

Initial NPI Registration & Enumeration October 17, 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: 1144300542

Entity Type:

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

Enumeration Date: October 17, 2006

Last Update: November 14, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

21911 76th Ave W, Suite 101

Edmonds, WA 980267903

Phone: 4257747723

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

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