Benchmarks
Ophthalmology financial benchmarks
How does your ophthalmology practice compare? Below is what is actually published for this specialty, with the source sitting next to it — and, for the metrics nobody publishes, how to work the number out from your own books.
These ranges are directional, not prescriptive — a starting point for diagnosis, not a target. Where a figure comes from a published source, that source is linked on the page; where it does not, it reflects Sorso's own compiled experience.
Linked sources carry their own publication dates, shown with each citation. Unlinked ranges were last reviewed August 2026.
What is actually published for ophthalmology
No industry body publishes financial benchmarks for ophthalmology that we could verify — we checked, and we would rather tell you that than invent a range. So this page does the more useful thing: for each metric, how to calculate it from your own numbers, what it actually tells you, and the specific way practices get it wrong.
Profit Margin
Nobody publishes this for ophthalmology.
- How to calculate it
- Net income divided by total collections, for the same period. Decide up front whether owner and provider compensation sits above or below that line, and keep it consistent. It is the single biggest reason two practices quote wildly different margins.
- What it tells you
- What is actually left after the practice pays for itself. Margin moves for only two reasons: the revenue per visit changed, or the cost of delivering that visit changed. Working out which one is the whole diagnosis.
- Where practices get it wrong
- Comparing a margin measured before owner pay against a published figure measured after it, or the reverse. Association surveys usually report owner income after compensation, which runs materially lower than an operating margin. The two are not the same number and should never be compared directly.
Overhead Ratio
Nobody publishes this for ophthalmology.
- How to calculate it
- Total operating expenses divided by total collections. Use collections, not production or billed charges. Billing what you never collect flatters the ratio.
- What it tells you
- The share of every dollar collected that is consumed before the owner is paid. It is the fastest read on whether a revenue problem is really a cost problem.
- Where practices get it wrong
- Running the ratio against production instead of collections. A practice with a collections problem then looks efficient, because the denominator includes money that never arrived.
Revenue per Provider
Nobody publishes this for ophthalmology.
- How to calculate it
- Total collections divided by clinical full-time equivalents, not headcount. Two half-time providers are one FTE, and counting them as two halves the figure for no real reason.
- What it tells you
- Whether capacity is the constraint or demand is. If revenue per provider is flat while headcount grows, you are adding cost without adding throughput.
- Where practices get it wrong
- Counting non-clinical or supervising staff in the denominator, and mixing provider types with very different reimbursement in one average.
Collection Rate
Nobody publishes this for ophthalmology.
- How to calculate it
- Payments received divided by what payers actually allowed, after contractual adjustments. That is the net collection rate, and it is the only version worth tracking.
- What it tells you
- How much of the money you were entitled to actually reached the bank. It isolates a billing-and-follow-up problem from a fee-schedule problem.
- Where practices get it wrong
- Two different formulas share this name. Payments divided by payments-plus-adjustments produces a much lower number than payments divided by allowed amount, and figures computed the two ways are not comparable. Check which one a published benchmark means before measuring yourself against it.
Denial Rate
Nobody publishes this for ophthalmology.
- How to calculate it
- Claims denied on first submission divided by total claims submitted, in the same period. Track first-pass specifically. A claim that is denied, reworked and eventually paid still cost you the rework.
- What it tells you
- Where revenue is leaking before it ever becomes A/R. The denial reason codes matter far more than the headline rate: a rate driven by eligibility errors is a front-desk fix, one driven by coding is not.
- Where practices get it wrong
- Measuring denials against claims paid rather than claims submitted, which understates the rate, and counting a reworked claim as never having been denied.
A/R Days
Nobody publishes this for ophthalmology.
- How to calculate it
- Total accounts receivable divided by average daily charges. Read it alongside the share of A/R over 90 and 120 days. The average alone hides a tail of old claims that will never be collected.
- What it tells you
- How long your money sits with someone else. The aged buckets are the actionable part; a respectable average with a fat 120-day tail is a worse position than a slightly higher average that is clean.
- Where practices get it wrong
- Leaving long-dead claims on the ledger so the aged buckets look survivable, and mixing payer types with structurally different payment speeds. Workers' comp and personal injury run far longer than commercial and will distort a blended figure.
Where the money goes
No published cost breakdown exists for ophthalmology that we could verify, so here is how to build your own. Take twelve months of P&L and group every expense line into staffing, occupancy, clinical supplies, equipment, marketing, insurance and everything else, each as a percentage of collections. Run it monthly rather than annually. An annual view hides the month a locum, a lease renewal or an equipment failure blew a hole in the number, and those single months are usually where the story is. The useful question is not whether any one line matches another practice. It is which line moved, and when. Staffing is almost always the largest line and the one worth attacking first: an overhead problem that looks like rent is usually a staffing-ratio problem.
Payer mix
We are not going to show you a national payer split, because one would tell you nothing useful. Payer mix is set by your market, your contracts and your referral pattern, and the national average is an artefact of averaging practices that have nothing to do with each other. Pull your own instead: collections by payer for the last twelve months, as a share of the total. Then do the part most practices skip and put net collection rate and average days to pay beside each payer. Concentration is only a risk when it sits with a slow payer or a low one. A practice at 60% commercial with a 40-day cycle is in a stronger position than one spread evenly across five payers where two of them take ninety days to pay.
What separates the strongest practices
No industry body publishes a top-quartile study for outpatient specialties, so this page will not print one. What we can tell you is what the gap tends to be made of, and it is rarely the fee schedule. It is usually visibility. A practice that measures its net collection rate against the allowed amount can see leakage; one that measures against billed charges cannot see it at all. Denials worked by reason code inside two weeks get appealed, while the same denials reworked at sixty days hit windows that have already started closing. Revenue and cost per visit tracked by provider will surface a weak provider or an underpriced service line, and the aggregate number never will. Then there is the aged A/R: a respectable average sitting on a fat 120-day tail is a worse position than a slightly higher average that is clean, and only the buckets tell you which one you have.
KPIs specific to ophthalmology
| KPI | Benchmark | Description |
|---|---|---|
| Surgical Cases per Month | 40–80 | Ophthalmology monthly surgical volume per surgeon (benchmark 40–80 cases); cataract and refractive cases drive the bulk of premium revenue capture. No published source states this figure. Treat it as a directional working figure, not an industry statistic. |
| Premium IOL Conversion Rate | 15–25% | Percentage of cataract patients choosing premium (out-of-pocket) intraocular lenses; national average is 15–18%, with top-quartile practices reaching 25%+. No published source states this figure. Treat it as a directional working figure, not an industry statistic. |
| Optical Revenue per Patient | $120–$200 | Revenue from eyewear and contact lens sales per patient; high-margin ancillary stream. No published source states this figure. Treat it as a directional working figure, not an industry statistic. |
| ASC Facility Fee Capture Rate | 90–95% | Percentage of eligible surgeries performed in the practice's own ambulatory surgery center. No published source states this figure. Treat it as a directional working figure, not an industry statistic. |
Each row’s description says where its figure comes from. Rows that name a source are linked under Sources at the foot of this page. Rows that say no published source states the figure mean exactly that: treat them as directional, and check the number against your own books before you act on it.
From Sorso
In the ophthalmology groups Sorso works with, premium IOL conversion and ASC capture are the two dials that matter most — moving conversion from 25% to 35% typically adds 4–6 points of EBITDA.
Where these numbers come from
No industry body publishes a benchmark set for ophthalmology practices that we have been able to verify, and we will not attach someone else’s name to numbers they did not publish. The ranges on this page are unverified working figures. Use them to frame a question, not to answer one — and check your own numbers before acting on any of it.
Where a published source states a figure, it is linked above. Ranges without a linked source are Sorso's own compiled estimates from client work and secondary industry reporting — they are not published association benchmarks, and we would rather say so than imply a citation we cannot show you.
Founder of Sorso and a CFA charterholder. Before Sorso, Stan spent 19 years in corporate finance at institutions including UniCredit and Société Générale — managing a $450M loan portfolio and making senior partner at a major mezzanine lender by 29 — then built a fractional CFO firm exclusively for outpatient healthcare clinics.
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