CPT code 92004: Comprehensive eye exam, new patient, one or more visits2026 Medicare rate & RVUs in Bartlett, Illinois
CPT 92004: $152.23–$153.46 office ($79.70–$80.06 facility) across 2 localities in Bartlett, IL in 2026 Medicare. Compare each area.
Medicare pays $152.23–$153.46 for 92004 in the office in Bartlett, Illinois, from Chicago, IL to Suburban Chicago, IL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 6 sections
Where 92004 pays more and less in Bartlett, Illinois
Bartlett, Illinois maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $152.23 | $80.06 |
| Suburban Chicago, IL | $153.46 | $79.70 |
How payment areas work in Bartlett
City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.
- Chicago · Cook County
- Suburban Chicago · DuPage County, Kane County
City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions
How the 92004 rate is calculated
Each of 92004’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 92004
RVUs × geographic indexes × conversion factor
Work1.82
1.82 RVUs× 1.000 GPCI
Practice expense2.62
2.62 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
4.4800
Conversion factor
$33.4009
Medicare rate
$149.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92004
The CMS indicators that decide how 92004 is paid alongside other services.
CMS payment indicators · 92004
Comprehensive eye exam, new patient, one or more visits
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 92004 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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