CPT code 92014: Comprehensive eye exam, established patient2026 Medicare rate & RVUs in Washington, DC area

Report a comprehensive ophthalmic evaluation of an established patient when the visual system is assessed and a diagnostic or treatment plan is initiated or continued.

CMS RVU26DEffective Oct 1, 2026One payment locality9.2M Medicare services in 2024

In Washington, DC area, Medicare pays $143.94 for 92014 in the office and $67.22 when it’s performed in a hospital or facility.

$143.94Office (non-facility)
$67.22Hospital or facility
+13.1%vs the national office rate ($127.26)

Check a contract rate as a % of Medicare · 92014 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 92014 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 92014 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 92014 covers

An ophthalmologist or optometrist performs this comprehensive assessment for an established patient, usually in an eye care office. Established status depends on professional services within the preceding three years from the clinician or a clinician of the same specialty and subspecialty in the same group. The evaluation addresses the visual system through history, general medical observation, external and ophthalmoscopic examinations, gross visual fields, and a basic sensorimotor assessment. Slit-lamp examination, tonometry, or dilation may be included when indicated. Common medical reasons include glaucoma follow-up, cataract evaluation, and diabetic retinopathy monitoring.

Report 92014 once for the comprehensive service, even if completed over multiple visits; use 92012 for an intermediate examination. The record should support the examination scope, medical reason, and initiation or continuation of a diagnostic or treatment plan. Medicare does not cover routine eye exams without a medical indication. Refraction, when performed, is separately reported with 92015 and excluded from Medicare coverage; medically necessary visual field testing or retinal imaging may also be reported separately. The code covers one or both eyes and is already priced as bilateral, so 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 Washington, DC area compares for 92014

Across 109 of 109 payment localities, the office rate for 92014 runs from $115.54 in Arkansas to $166.55 in San Benito County, CA. Washington, DC area pays $143.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

92014 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$143.94
  2. Los Angeles, CA · California$143.12−$0.82
  3. Miami, FL · Florida$132.52−$11.42
  4. Chicago, IL · Illinois$129.71−$14.23
  5. Manhattan, NY · New York$143.79−$0.15
  6. Alaska · Alaska$155.47+$11.53
  7. Alabama · Alabama$116.87−$27.07

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

92014 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$115.54$59.59
ArizonaArizona$124.63$61.52
Bakersfield, CACalifornia$135.17$63.79
Chico, CACalifornia$134.98$63.59
El Centro, CACalifornia$134.99$63.60
Fresno, CACalifornia$134.98$63.59
Hanford, CACalifornia$134.98$63.59
Madera, CACalifornia$134.98$63.59

92014 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.

$115.54

$155.47

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92014 office rate range by state
State / territoryOffice rate rangeLocalities
AK$155.471
AL$116.871
AR$115.541
AZ$124.631
CA$134.98–$166.5529
CO$132.561
CT$134.531
DC$143.941
DE$126.421
FL$124.48–$132.523
GA$119.04–$128.922
GU$137.451
HI$137.451
IA$119.781
ID$120.271
IL$121.18–$130.744
IN$120.841
KS$119.061
KY$118.431
LA$118.17–$122.812
MA$131.91–$144.282
MD$128.56–$143.943
ME$120.47–$126.062
MI$120.60–$125.432
MN$128.591
MO$116.39–$123.493
MS$116.001
MT$127.251
NC$121.521
ND$126.461
NE$120.381
NH$130.311
NJ$136.51–$142.902
NM$121.011
NV$127.111
NY$122.94–$146.275
OH$120.441
OK$118.561
OR$126.55–$136.392
PA$120.75–$131.592
PR$128.101
RI$130.601
SC$121.091
SD$126.371
TN$119.501
TX$120.10–$131.758
UT$122.411
VA$125.53–$143.942
VI$128.101
VT$125.811
WA$131.71–$147.202
WI$123.041
WV$117.551
WY$126.911

See 92014 in every payment locality

How the 92014 rate is calculated

Each of 92014’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 · 92014

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.42

1.42 RVUs× 1.000 GPCI

Practice expense2.35

2.35 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

3.8100

Conversion factor

$33.4009

Medicare rate

$127.26

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,662

Code
92014
Physician work
1.42
Practice expense
2.35
Malpractice
0.04

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 92014 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.42× 1.0541.4967
Practice expense2.35× 1.1782.7683
Malpractice0.04× 1.1130.0445
Total RVUs4.3095
Conversion factor× 33.4009

Office rate, Washington, DC area$143.94

Office: (1.42 × 1.054 + 2.35 × 1.178 + 0.04 × 1.113) × $33.4009 = $143.94

Facility: (1.42 × 1.054 + 0.4 × 1.178 + 0.04 × 1.113) × $33.4009 = $67.22

Open 92014 in the RVU calculator

Payment rules and modifiers for 92014

The CMS indicators that decide how 92014 is paid alongside other services.

CMS payment indicators · 92014

Comprehensive eye exam, established patient

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 92014 has changed in Washington, DC area

92014 · Office / nonfacility

$143.94

Effective 2026-10-01

The base rate is $5.97 higher than on 2025-10-01, moving from $137.97 to $143.94 (4.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $137.97changed to$143.94

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.28 changed to 2.35
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $143.18changed to$137.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.31 changed to 2.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $140.84changed to$143.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $146.69changed to$140.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.29 changed to 2.31
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $149.85changed to$146.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.24 changed to 2.29
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $149.79changed to$149.85

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.21 changed to 2.24

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $147.72changed to$149.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.08 changed to 2.21
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $146.97changed to$147.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.09 changed to 2.08
    • Malpractice RVU 0.06 changed to 0.05
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $146.81changed to$146.97

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $143.07changed to$146.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.01 changed to 2.09
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $142.47changed to$143.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.00 changed to 2.01
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $142.53changed to$142.47

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.05 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $141.82changed to$142.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $143.85changed to$141.82

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.10 changed to 0.05
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $143.79changed to$143.85

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.19 changed to 2.00
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $143.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$143.94$67.22RVU26D
2026-07-01$143.94$67.22RVU26C
2026-04-01$143.94$67.22RVU26B
2026-01-01$143.94$67.22RVU26A
2025-10-01$137.97$79.75RVU25D
2025-07-01$137.97$79.75RVU25C
2025-04-01$137.97$79.75RVU25B
2025-01-01$137.97$79.75RVU25A
2024-10-01$143.18$82.07RVU24D
2024-07-01$143.18$82.07RVU24C
2024-04-01$143.18$82.07RVU24B
2024-03-09$143.18$82.07RVU24AR
2024-01-01$140.84$80.73RVU24A
2023-10-01$146.69$84.57RVU23D
2023-07-01$146.69$84.57RVU23C
2023-04-01$146.69$84.57RVU23B
2023-01-01$146.69$84.57RVU23A
2022-10-01$149.85$86.54RVU22D
2022-07-01$149.85$86.54RVU22C
2022-04-01$149.85$86.54RVU22B
2022-01-01$149.85$86.54RVU22A
2021-10-01$149.79$87.26RVU21D
2021-07-01$149.79$87.26RVU21C
2021-04-01$149.79$87.26RVU21B
2021-01-01$149.79$87.26RVU21A
2020-10-01$147.72$89.55RVU20D
2020-07-01$147.72$89.55RVU20C
2020-04-01$147.72$89.55RVU20B
2020-01-01$147.72$89.55RVU20A
2019-10-01$146.97$89.64RVU19D
2019-07-01$146.97$89.64RVU19C
2019-04-01$146.97$89.64RVU19B
2019-01-01$146.97$89.64RVU19A
2018-10-01$146.81$89.98RVU18D
2018-07-01$146.81$89.98RVU18C
2018-04-01$146.81$89.98RVU18B
2018-01-01$146.81$89.98RVU18AR1
2017-10-01$143.07$90.31RVU17D
2017-07-01$143.07$90.31RVU17C
2017-04-01$143.07$90.31RVU17B
2017-01-01$143.07$90.31RVU17A
2016-10-01$142.47$89.84RVU16D
2016-07-01$142.47$89.84RVU16C
2016-04-01$142.47$89.84RVU16B
2016-01-01$142.47$89.84RVU16A
2015-10-01$142.53$89.70RVU15D
2015-07-01$142.53$89.70RVU15C
2015-04-01$141.82$89.26RVU15B
2015-01-01$141.82$89.26RVU15A
2014-10-01$143.85$91.75RVU14D
2014-07-01$143.85$91.75RVU14C
2014-04-01$143.85$91.75RVU14B
2014-01-01$143.85$91.75RVU14A
2013-10-01$143.79$88.76RVU13D
2013-07-01$143.79$88.76RVU13C
2013-04-01$143.79$88.76RVU13B
2013-01-01$143.79$88.76RVU13AR

Price 92014 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

92014 billing questions

When should 92014 be chosen over 92012?

Use 92014 when the documented examination covers the comprehensive visual system assessment and initiates or continues a diagnostic or treatment plan. Use 92012 for an intermediate examination that does not meet that comprehensive scope.

Is refraction included in 92014?

No. Report a separately performed refraction with 92015; Medicare excludes refraction from coverage.

Should modifier RT, LT, or 50 be appended?

Routine reporting of 92014 does not require RT or LT; document the eye or eyes examined. The code covers one or both eyes and is already priced as bilateral, so modifier 50 does not increase payment.

Can an office E/M code be billed instead of 92014?

Yes. An eye care provider may report an office E/M code instead when its documentation requirements are met. Do not report both an office E/M code and 92014 for the same examination.

What qualifies the patient as established for this code?

The patient has received professional services within the preceding three years from the provider or another provider of the same specialty and subspecialty in the same group. If the patient is new, consider 92004 when a comprehensive ophthalmic examination is performed.

Does Medicare pay for an annual comprehensive exam with no complaints?

An annual schedule alone does not establish coverage. A medically indicated examination, such as glaucoma surveillance or diabetic retinal disease monitoring, may qualify even without new complaints; routine vision screening is not covered.

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
RVUs for 92014PPRRVU2026_Oct_nonQPP.csv, line 11,662 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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