CPT code 92012: Eye exam, intermediate, established patient2026 Medicare rate & RVUs in Mississippi
An intermediate ophthalmological exam is reported when an ophthalmologist or optometrist evaluates a defined eye concern in an established patient without performing a comprehensive exam.
In Mississippi, Medicare pays $82.08 for 92012 in the office and $39.81 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 92012 nationwide
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 11 sections
What 92012 covers
An intermediate ophthalmological examination addresses a defined eye concern or interval reassessment in a returning patient. The ophthalmologist or optometrist obtains an interval history, makes general medical observations, examines the external eye and surrounding structures, and performs other diagnostic steps as indicated. The examination may involve one eye or both and may include dilation when needed. The clinician establishes or updates a diagnostic and treatment plan based on the findings. This service is commonly furnished in an office or outpatient eye clinic.
Report 92012 when the patient qualifies as established and the documented examination supports an intermediate rather than comprehensive ophthalmological service. Record the presenting concern, pertinent history, examined structures, findings, and diagnostic and treatment plan. A comprehensive evaluation of the visual system is reported with 92014 instead. Refraction, if performed, is reported separately with 92015. Medically necessary visual field or retinal imaging tests require separate documentation to support reporting them alongside the exam. CMS prices 92012 as bilateral, so examining both eyes does not support two units, and modifier 50 does not increase payment.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Mississippi compares for 92012
Across 109 of 109 payment localities, the office rate for 92012 runs from $81.74 in Arkansas to $119.41 in San Benito County, CA. Mississippi pays $82.08. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Mississippi · this page$82.08
- Los Angeles, CA · California$102.20+$20.12
- Washington, DC area · District of Columbia$102.75+$20.67
- Miami, FL · Florida$94.46+$12.38
- Chicago, IL · Illinois$92.32+$10.24
- Manhattan, NY · New York$102.59+$20.51
- Alaska · Alaska$109.25+$27.17
Other areas in Mississippi first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $82.73 | $39.77 |
| ArkansasArkansas | $81.74 | $39.57 |
| ArizonaArizona | $88.55 | $40.97 |
| Bakersfield, CACalifornia | $96.35 | $42.54 |
| Chico, CACalifornia | $96.22 | $42.40 |
| El Centro, CACalifornia | $96.22 | $42.41 |
| Fresno, CACalifornia | $96.22 | $42.40 |
| Hanford, CACalifornia | $96.22 | $42.40 |
| Madera, CACalifornia | $96.22 | $42.40 |
| Merced, CACalifornia | $96.22 | $42.40 |
| Modesto, CACalifornia | $96.22 | $42.40 |
| Napa, CACalifornia | $110.65 | $45.94 |
| Oxnard, CACalifornia | $101.70 | $43.66 |
| Redding, CACalifornia | $96.22 | $42.40 |
| Rest of CaliforniaCalifornia | $96.22 | $42.40 |
| Riverside, CACalifornia | $96.57 | $42.75 |
| Sacramento, CACalifornia | $100.74 | $43.64 |
| Salinas, CACalifornia | $100.35 | $43.44 |
| San Diego, CACalifornia | $102.50 | $43.78 |
| Marin County, CACalifornia | $117.00 | $47.77 |
| San Francisco, CACalifornia | $116.96 | $47.73 |
| San Benito County, CACalifornia | $119.41 | $48.61 |
| Santa Clara County, CACalifornia | $119.28 | $48.47 |
| San Luis Obispo, CACalifornia | $98.75 | $42.82 |
| Santa Cruz, CACalifornia | $103.34 | $43.68 |
| Santa Maria, CACalifornia | $100.67 | $43.42 |
| Santa Rosa, CACalifornia | $104.38 | $44.08 |
| Stockton, CACalifornia | $96.22 | $42.40 |
| Vallejo, CACalifornia | $110.60 | $45.89 |
| Visalia, CACalifornia | $96.22 | $42.40 |
| Yuba City, CACalifornia | $96.22 | $42.40 |
| ColoradoColorado | $94.43 | $42.19 |
| ConnecticutConnecticut | $95.87 | $42.99 |
| DelawareDelaware | $89.86 | $41.35 |
| Fort Lauderdale, FLFlorida | $92.09 | $42.35 |
| Rest of FloridaFlorida | $88.43 | $41.49 |
| Atlanta, GAGeorgia | $91.75 | $41.87 |
| Rest of GeorgiaGeorgia | $84.36 | $40.56 |
| Hawaii, Guam, HIHawaii | $98.15 | $42.32 |
| IowaIowa | $84.92 | $39.99 |
| IdahoIdaho | $85.29 | $40.11 |
| East St. Louis, ILIllinois | $86.83 | $41.66 |
| Rest of IllinoisIllinois | $85.97 | $41.14 |
| Suburban Chicago, ILIllinois | $93.09 | $42.67 |
| IndianaIndiana | $85.71 | $40.19 |
| KansasKansas | $84.38 | $39.99 |
| KentuckyKentucky | $83.91 | $40.26 |
| New Orleans, LALouisiana | $87.18 | $40.98 |
| Rest of LouisianaLouisiana | $83.71 | $40.26 |
| Metropolitan Boston, MAMassachusetts | $103.07 | $44.45 |
| Rest of MassachusettsMassachusetts | $93.92 | $42.22 |
| Baltimore area, MDMaryland | $95.54 | $42.85 |
| Rest of MarylandMaryland | $91.45 | $41.76 |
| Rest of MaineMaine | $85.43 | $40.26 |
| Southern Maine, MEMaine | $89.62 | $40.96 |
| Detroit, MIMichigan | $89.15 | $41.77 |
| Rest of MichiganMichigan | $85.53 | $40.70 |
| MinnesotaMinnesota | $91.52 | $40.99 |
| Metropolitan Kansas City, MOMissouri | $86.91 | $40.80 |
| Metropolitan St. Louis, MOMissouri | $87.70 | $40.95 |
| Rest of MissouriMissouri | $82.38 | $40.05 |
| MontanaMontana | $90.51 | $41.42 |
| North CarolinaNorth Carolina | $86.22 | $40.41 |
| North DakotaNorth Dakota | $89.92 | $40.82 |
| NebraskaNebraska | $85.37 | $40.05 |
| New HampshireNew Hampshire | $92.80 | $41.69 |
| Northern New JerseyNew Jersey | $101.93 | $44.97 |
| Rest of New JerseyNew Jersey | $97.25 | $43.63 |
| New MexicoNew Mexico | $85.84 | $40.81 |
| NevadaNevada | $90.41 | $41.26 |
| NYC suburbs and Long Island, NYNew York | $104.45 | $46.07 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $97.69 | $43.93 |
| Queens, NYNew York | $103.62 | $45.59 |
| Rest of New YorkNew York | $87.28 | $40.64 |
| OhioOhio | $85.41 | $40.58 |
| OklahomaOklahoma | $84.00 | $40.16 |
| Portland, OROregon | $97.28 | $42.73 |
| Rest of OregonOregon | $89.98 | $41.08 |
| Metropolitan Philadelphia, PAPennsylvania | $93.67 | $42.56 |
| Rest of PennsylvaniaPennsylvania | $85.64 | $40.57 |
| Puerto RicoPuerto Rico | $91.15 | $41.51 |
| Rhode IslandRhode Island | $92.93 | $42.21 |
| South CarolinaSouth Carolina | $85.90 | $40.53 |
| South DakotaSouth Dakota | $89.85 | $40.75 |
| TennesseeTennessee | $84.70 | $40.07 |
| Austin, TXTexas | $93.87 | $41.93 |
| Beaumont, TXTexas | $85.15 | $40.47 |
| Brazoria, TXTexas | $90.01 | $41.36 |
| Dallas, TXTexas | $90.42 | $41.51 |
| Fort Worth, TXTexas | $89.84 | $41.43 |
| Galveston, TXTexas | $90.18 | $41.42 |
| Houston, TXTexas | $90.73 | $41.97 |
| Rest of TexasTexas | $87.42 | $40.83 |
| UtahUtah | $86.89 | $40.73 |
| VirginiaVirginia | $89.22 | $40.96 |
| Virgin Islands, VIUnited States Virgin Islands | $91.15 | $41.51 |
| VermontVermont | $89.43 | $40.83 |
| Rest of WashingtonWashington | $93.79 | $42.09 |
| King County, WAWashington | $105.21 | $44.97 |
| WisconsinWisconsin | $87.35 | $40.32 |
| West VirginiaWest Virginia | $83.25 | $40.58 |
| WyomingWyoming | $90.26 | $41.16 |
92012 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$81.74
$109.25
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $109.25 | 1 |
| AL | $82.73 | 1 |
| AR | $81.74 | 1 |
| AZ | $88.55 | 1 |
| CA | $96.22–$119.41 | 29 |
| CO | $94.43 | 1 |
| CT | $95.87 | 1 |
| DC | $102.75 | 1 |
| DE | $89.86 | 1 |
| FL | $88.43–$94.46 | 3 |
| GA | $84.36–$91.75 | 2 |
| GU | $98.15 | 1 |
| HI | $98.15 | 1 |
| IA | $84.92 | 1 |
| ID | $85.29 | 1 |
| IL | $85.97–$93.09 | 4 |
| IN | $85.71 | 1 |
| KS | $84.38 | 1 |
| KY | $83.91 | 1 |
| LA | $83.71–$87.18 | 2 |
| MA | $93.92–$103.07 | 2 |
| MD | $91.45–$102.75 | 3 |
| ME | $85.43–$89.62 | 2 |
| MI | $85.53–$89.15 | 2 |
| MN | $91.52 | 1 |
| MO | $82.38–$87.70 | 3 |
| MS | $82.08 | 1 |
| MT | $90.51 | 1 |
| NC | $86.22 | 1 |
| ND | $89.92 | 1 |
| NE | $85.37 | 1 |
| NH | $92.80 | 1 |
| NJ | $97.25–$101.93 | 2 |
| NM | $85.84 | 1 |
| NV | $90.41 | 1 |
| NY | $87.28–$104.45 | 5 |
| OH | $85.41 | 1 |
| OK | $84.00 | 1 |
| OR | $89.98–$97.28 | 2 |
| PA | $85.64–$93.67 | 2 |
| PR | $91.15 | 1 |
| RI | $92.93 | 1 |
| SC | $85.90 | 1 |
| SD | $89.85 | 1 |
| TN | $84.70 | 1 |
| TX | $85.15–$93.87 | 8 |
| UT | $86.89 | 1 |
| VA | $89.22–$102.75 | 2 |
| VI | $91.15 | 1 |
| VT | $89.43 | 1 |
| WA | $93.79–$105.21 | 2 |
| WI | $87.35 | 1 |
| WV | $83.25 | 1 |
| WY | $90.26 | 1 |
How the 92012 rate is calculated
Each of 92012’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 · 92012
RVUs × geographic indexes × conversion factor
Work0.92
0.92 RVUs× 1.000 GPCI
Practice expense1.76
1.76 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
2.7100
Conversion factor
$33.4009
Medicare rate
$90.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Mississippi inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,661
- Code
- 92012
- Physician work
- 0.92
- Practice expense
- 1.76
- Malpractice
- 0.03
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.92 | × 1.000 | 0.9200 |
| Practice expense | 1.76 | × 0.861 | 1.5154 |
| Malpractice | 0.03 | × 0.739 | 0.0222 |
| Total RVUs | 2.4575 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Mississippi$82.08
Office: (0.92 × 1 + 1.76 × 0.861 + 0.03 × 0.739) × $33.4009 = $82.08
Facility: (0.92 × 1 + 0.29 × 0.861 + 0.03 × 0.739) × $33.4009 = $39.81
Payment rules and modifiers for 92012
The CMS indicators that decide how 92012 is paid alongside other services.
CMS payment indicators · 92012
Eye exam, intermediate, established patient
| 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. |
How 92012 has changed in Mississippi
92012 · Office / nonfacility
$82.08
Effective 2026-10-01
The base rate is $5.00 higher than on 2025-10-01, moving from $77.08 to $82.08 (6.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$77.08changed to$82.08
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.69 changed to 1.76
- Practice expense GPCI 0.852 changed to 0.861
- Malpractice GPCI 0.768 changed to 0.739
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$80.17changed to$77.08
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.72 changed to 1.69
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$78.86changed to$80.17
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$81.23changed to$78.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.71 changed to 1.72
- Malpractice RVU 0.04 changed to 0.03
- Practice expense GPCI 0.847 changed to 0.852
- Malpractice GPCI 0.720 changed to 0.768
January 1, 2023
RVU23A
$81.14changed to$81.23
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.66 changed to 1.71
- Practice expense GPCI 0.842 changed to 0.847
- Malpractice GPCI 0.671 changed to 0.720
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$81.52changed to$81.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.65 changed to 1.66
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$81.34changed to$81.52
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.54 changed to 1.65
- Malpractice RVU 0.03 changed to 0.04
- Practice expense GPCI 0.856 changed to 0.842
- Malpractice GPCI 0.521 changed to 0.671
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$81.66changed to$81.34
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.53 changed to 1.54
- Malpractice RVU 0.04 changed to 0.03
- Practice expense GPCI 0.870 changed to 0.856
- Malpractice GPCI 0.370 changed to 0.521
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$81.26changed to$81.66
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.52 changed to 1.53
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$78.84changed to$81.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.45 changed to 1.52
- Practice expense GPCI 0.867 changed to 0.870
- Malpractice GPCI 0.492 changed to 0.370
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$78.36changed to$78.84
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.44 changed to 1.45
- Practice expense GPCI 0.864 changed to 0.867
- Malpractice GPCI 0.613 changed to 0.492
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$78.74changed to$78.36
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.45 changed to 1.44
- Malpractice RVU 0.03 changed to 0.04
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$78.35changed to$78.74
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$79.30changed to$78.35
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.44 changed to 1.45
- Malpractice RVU 0.07 changed to 0.03
- Practice expense GPCI 0.865 changed to 0.864
- Malpractice GPCI 0.687 changed to 0.613
Held through RVU15B.
January 1, 2014
RVU14A
$79.67changed to$79.30
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.58 changed to 1.44
- Practice expense GPCI 0.866 changed to 0.865
- Malpractice GPCI 0.761 changed to 0.687
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $79.67
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $82.08 | $39.81 | RVU26D |
| 2026-07-01 | $82.08 | $39.81 | RVU26C |
| 2026-04-01 | $82.08 | $39.81 | RVU26B |
| 2026-01-01 | $82.08 | $39.81 | RVU26A |
| 2025-10-01 | $77.08 | $45.11 | RVU25D |
| 2025-07-01 | $77.08 | $45.11 | RVU25C |
| 2025-04-01 | $77.08 | $45.11 | RVU25B |
| 2025-01-01 | $77.08 | $45.11 | RVU25A |
| 2024-10-01 | $80.17 | $46.42 | RVU24D |
| 2024-07-01 | $80.17 | $46.42 | RVU24C |
| 2024-04-01 | $80.17 | $46.42 | RVU24B |
| 2024-03-09 | $80.17 | $46.42 | RVU24AR |
| 2024-01-01 | $78.86 | $45.67 | RVU24A |
| 2023-10-01 | $81.23 | $47.36 | RVU23D |
| 2023-07-01 | $81.23 | $47.36 | RVU23C |
| 2023-04-01 | $81.23 | $47.36 | RVU23B |
| 2023-01-01 | $81.23 | $47.36 | RVU23A |
| 2022-10-01 | $81.14 | $47.92 | RVU22D |
| 2022-07-01 | $81.14 | $47.92 | RVU22C |
| 2022-04-01 | $81.14 | $47.92 | RVU22B |
| 2022-01-01 | $81.14 | $47.92 | RVU22A |
| 2021-10-01 | $81.52 | $48.32 | RVU21D |
| 2021-07-01 | $81.52 | $48.32 | RVU21C |
| 2021-04-01 | $81.52 | $48.32 | RVU21B |
| 2021-01-01 | $81.52 | $48.32 | RVU21A |
| 2020-10-01 | $81.34 | $49.83 | RVU20D |
| 2020-07-01 | $81.34 | $49.83 | RVU20C |
| 2020-04-01 | $81.34 | $49.83 | RVU20B |
| 2020-01-01 | $81.34 | $49.83 | RVU20A |
| 2019-10-01 | $81.66 | $50.31 | RVU19D |
| 2019-07-01 | $81.66 | $50.31 | RVU19C |
| 2019-04-01 | $81.66 | $50.31 | RVU19B |
| 2019-01-01 | $81.66 | $50.31 | RVU19A |
| 2018-10-01 | $81.26 | $50.57 | RVU18D |
| 2018-07-01 | $81.26 | $50.57 | RVU18C |
| 2018-04-01 | $81.26 | $50.57 | RVU18B |
| 2018-01-01 | $81.26 | $50.57 | RVU18AR1 |
| 2017-10-01 | $78.84 | $50.53 | RVU17D |
| 2017-07-01 | $78.84 | $50.53 | RVU17C |
| 2017-04-01 | $78.84 | $50.53 | RVU17B |
| 2017-01-01 | $78.84 | $50.53 | RVU17A |
| 2016-10-01 | $78.36 | $50.21 | RVU16D |
| 2016-07-01 | $78.36 | $50.21 | RVU16C |
| 2016-04-01 | $78.36 | $50.21 | RVU16B |
| 2016-01-01 | $78.36 | $50.21 | RVU16A |
| 2015-10-01 | $78.74 | $50.17 | RVU15D |
| 2015-07-01 | $78.74 | $50.17 | RVU15C |
| 2015-04-01 | $78.35 | $49.92 | RVU15B |
| 2015-01-01 | $78.35 | $49.92 | RVU15A |
| 2014-10-01 | $79.30 | $51.41 | RVU14D |
| 2014-07-01 | $79.30 | $51.41 | RVU14C |
| 2014-04-01 | $79.30 | $51.41 | RVU14B |
| 2014-01-01 | $79.30 | $51.41 | RVU14A |
| 2013-10-01 | $79.67 | $49.91 | RVU13D |
| 2013-07-01 | $79.67 | $49.91 | RVU13C |
| 2013-04-01 | $79.67 | $49.91 | RVU13B |
| 2013-01-01 | $79.67 | $49.91 | RVU13AR |
Where the Mississippi rate applies
Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Aberdeen
- Ackerman
- Agricola
- Alcorn State University
- Algoma
- Alligator
- Amory
92012 billing questions
When should 92014 be reported instead of 92012?
Use 92014 when the documented service is a comprehensive evaluation of the visual system. Use 92012 when the documented examination is intermediate in scope, with diagnostic steps directed by the patient's concern.
Can 92012 be billed with an office E/M code on the same date?
Do not report 92012 and an office E/M code such as 99213 for the same examination and management work. A distinct, separately documented E/M service may be reportable on the same date when its coding requirements are met.
Is refraction included in 92012?
No. Determining refractive error for a lens prescription is reported separately with 92015 when performed.
Should modifier 50 or RT and LT be appended when both eyes are examined?
Do not use modifier 50 to seek additional payment; CMS already prices 92012 as bilateral. RT and LT may identify the examined side when needed, but examining both eyes does not create two units.
Does dilation have to be performed to report 92012?
No. Dilation may be part of an intermediate examination when clinically indicated, but it is not required for this level.
Who counts as an established patient for this code?
A patient who received professional services from the same provider, or another provider of the same specialty in the same group, within the prior three years.
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
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