CPT code 92014: Comprehensive eye exam, established patient2026 Medicare rate & RVUs in South Dakota
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.
In South Dakota, Medicare pays $126.37 for 92014 in the office and $61.24 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $126.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$126.37
- Los Angeles, CA · California$143.12+$16.75
- Washington, DC area · District of Columbia$143.94+$17.57
- Miami, FL · Florida$132.52+$6.15
- Chicago, IL · Illinois$129.71+$3.34
- Manhattan, NY · New York$143.79+$17.42
- Alaska · Alaska$155.47+$29.10
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $116.87 | $59.88 |
| 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 |
| Merced, CACalifornia | $134.98 | $63.59 |
| Modesto, CACalifornia | $134.98 | $63.59 |
| Napa, CACalifornia | $154.55 | $68.70 |
| Oxnard, CACalifornia | $142.37 | $65.38 |
| Redding, CACalifornia | $134.98 | $63.59 |
| Rest of CaliforniaCalifornia | $134.98 | $63.59 |
| Riverside, CACalifornia | $135.45 | $64.07 |
| Sacramento, CACalifornia | $141.14 | $65.39 |
| Salinas, CACalifornia | $140.59 | $65.10 |
| San Diego, CACalifornia | $143.45 | $65.56 |
| Marin County, CACalifornia | $163.22 | $71.39 |
| San Francisco, CACalifornia | $163.18 | $71.34 |
| San Benito County, CACalifornia | $166.55 | $72.63 |
| Santa Clara County, CACalifornia | $166.36 | $72.44 |
| San Luis Obispo, CACalifornia | $138.35 | $64.17 |
| Santa Cruz, CACalifornia | $144.51 | $65.37 |
| Santa Maria, CACalifornia | $141.00 | $65.05 |
| Santa Rosa, CACalifornia | $145.96 | $65.97 |
| Stockton, CACalifornia | $134.98 | $63.59 |
| Vallejo, CACalifornia | $154.48 | $68.64 |
| Visalia, CACalifornia | $134.98 | $63.59 |
| Yuba City, CACalifornia | $134.98 | $63.59 |
| ColoradoColorado | $132.56 | $63.26 |
| ConnecticutConnecticut | $134.53 | $64.38 |
| DelawareDelaware | $126.42 | $62.07 |
| Fort Lauderdale, FLFlorida | $129.36 | $63.38 |
| Rest of FloridaFlorida | $124.48 | $62.21 |
| Atlanta, GAGeorgia | $128.92 | $62.75 |
| Rest of GeorgiaGeorgia | $119.04 | $60.94 |
| Hawaii, Guam, HIHawaii | $137.45 | $63.39 |
| IowaIowa | $119.78 | $60.18 |
| IdahoIdaho | $120.27 | $60.35 |
| East St. Louis, ILIllinois | $122.33 | $62.41 |
| Rest of IllinoisIllinois | $121.18 | $61.72 |
| Suburban Chicago, ILIllinois | $130.74 | $63.85 |
| IndianaIndiana | $120.84 | $60.46 |
| KansasKansas | $119.06 | $60.18 |
| KentuckyKentucky | $118.43 | $60.53 |
| New Orleans, LALouisiana | $122.81 | $61.52 |
| Rest of LouisianaLouisiana | $118.17 | $60.53 |
| Metropolitan Boston, MAMassachusetts | $144.28 | $66.52 |
| Rest of MassachusettsMassachusetts | $131.91 | $63.32 |
| Baltimore area, MDMaryland | $134.06 | $64.18 |
| Rest of MarylandMaryland | $128.56 | $62.65 |
| Rest of MaineMaine | $120.47 | $60.55 |
| Southern Maine, MEMaine | $126.06 | $61.51 |
| Detroit, MIMichigan | $125.43 | $62.57 |
| Rest of MichiganMichigan | $120.60 | $61.14 |
| MinnesotaMinnesota | $128.59 | $61.57 |
| Metropolitan Kansas City, MOMissouri | $122.44 | $61.28 |
| Metropolitan St. Louis, MOMissouri | $123.49 | $61.49 |
| Rest of MissouriMissouri | $116.39 | $60.25 |
| MississippiMississippi | $116.00 | $59.92 |
| MontanaMontana | $127.25 | $62.12 |
| North CarolinaNorth Carolina | $121.52 | $60.75 |
| North DakotaNorth Dakota | $126.46 | $61.33 |
| NebraskaNebraska | $120.38 | $60.27 |
| New HampshireNew Hampshire | $130.31 | $62.51 |
| Northern New JerseyNew Jersey | $142.90 | $67.34 |
| Rest of New JerseyNew Jersey | $136.51 | $65.38 |
| New MexicoNew Mexico | $121.01 | $61.29 |
| NevadaNevada | $127.11 | $61.92 |
| NYC suburbs and Long Island, NYNew York | $146.27 | $68.83 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $137.13 | $65.81 |
| Queens, NYNew York | $145.17 | $68.18 |
| Rest of New YorkNew York | $122.94 | $61.06 |
| OhioOhio | $120.44 | $60.97 |
| OklahomaOklahoma | $118.56 | $60.40 |
| Portland, OROregon | $136.39 | $64.03 |
| Rest of OregonOregon | $126.55 | $61.68 |
| Metropolitan Philadelphia, PAPennsylvania | $131.59 | $63.79 |
| Rest of PennsylvaniaPennsylvania | $120.75 | $60.96 |
| Puerto RicoPuerto Rico | $128.10 | $62.25 |
| Rhode IslandRhode Island | $130.60 | $63.32 |
| South CarolinaSouth Carolina | $121.09 | $60.91 |
| TennesseeTennessee | $119.50 | $60.29 |
| Austin, TXTexas | $131.75 | $62.84 |
| Beaumont, TXTexas | $120.10 | $60.83 |
| Brazoria, TXTexas | $126.64 | $62.09 |
| Dallas, TXTexas | $127.18 | $62.31 |
| Fort Worth, TXTexas | $126.41 | $62.19 |
| Galveston, TXTexas | $126.86 | $62.18 |
| Houston, TXTexas | $127.59 | $62.91 |
| Rest of TexasTexas | $123.12 | $61.31 |
| UtahUtah | $122.41 | $61.19 |
| VirginiaVirginia | $125.53 | $61.51 |
| Virgin Islands, VIUnited States Virgin Islands | $128.10 | $62.25 |
| VermontVermont | $125.81 | $61.33 |
| Rest of WashingtonWashington | $131.71 | $63.13 |
| King County, WAWashington | $147.20 | $67.29 |
| WisconsinWisconsin | $123.04 | $60.64 |
| West VirginiaWest Virginia | $117.55 | $60.95 |
| WyomingWyoming | $126.91 | $61.78 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $155.47 | 1 |
| AL | $116.87 | 1 |
| AR | $115.54 | 1 |
| AZ | $124.63 | 1 |
| CA | $134.98–$166.55 | 29 |
| CO | $132.56 | 1 |
| CT | $134.53 | 1 |
| DC | $143.94 | 1 |
| DE | $126.42 | 1 |
| FL | $124.48–$132.52 | 3 |
| GA | $119.04–$128.92 | 2 |
| GU | $137.45 | 1 |
| HI | $137.45 | 1 |
| IA | $119.78 | 1 |
| ID | $120.27 | 1 |
| IL | $121.18–$130.74 | 4 |
| IN | $120.84 | 1 |
| KS | $119.06 | 1 |
| KY | $118.43 | 1 |
| LA | $118.17–$122.81 | 2 |
| MA | $131.91–$144.28 | 2 |
| MD | $128.56–$143.94 | 3 |
| ME | $120.47–$126.06 | 2 |
| MI | $120.60–$125.43 | 2 |
| MN | $128.59 | 1 |
| MO | $116.39–$123.49 | 3 |
| MS | $116.00 | 1 |
| MT | $127.25 | 1 |
| NC | $121.52 | 1 |
| ND | $126.46 | 1 |
| NE | $120.38 | 1 |
| NH | $130.31 | 1 |
| NJ | $136.51–$142.90 | 2 |
| NM | $121.01 | 1 |
| NV | $127.11 | 1 |
| NY | $122.94–$146.27 | 5 |
| OH | $120.44 | 1 |
| OK | $118.56 | 1 |
| OR | $126.55–$136.39 | 2 |
| PA | $120.75–$131.59 | 2 |
| PR | $128.10 | 1 |
| RI | $130.60 | 1 |
| SC | $121.09 | 1 |
| SD | $126.37 | 1 |
| TN | $119.50 | 1 |
| TX | $120.10–$131.75 | 8 |
| UT | $122.41 | 1 |
| VA | $125.53–$143.94 | 2 |
| VI | $128.10 | 1 |
| VT | $125.81 | 1 |
| WA | $131.71–$147.20 | 2 |
| WI | $123.04 | 1 |
| WV | $117.55 | 1 |
| WY | $126.91 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.42 | × 1.000 | 1.4200 |
| Practice expense | 2.35 | × 1.000 | 2.3500 |
| Malpractice | 0.04 | × 0.336 | 0.0134 |
| Total RVUs | 3.7834 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$126.37
Office: (1.42 × 1 + 2.35 × 1 + 0.04 × 0.336) × $33.4009 = $126.37
Facility: (1.42 × 1 + 0.4 × 1 + 0.04 × 0.336) × $33.4009 = $61.24
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
| 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 92014 has changed in South Dakota
92014 · Office / nonfacility
$126.37
Effective 2026-10-01
The base rate is $6.19 higher than on 2025-10-01, moving from $120.18 to $126.37 (5.2%).
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
$120.18changed to$126.37
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 2.28 changed to 2.35
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$124.67changed to$120.18
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.31 changed to 2.28
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$122.64changed to$124.67
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$126.21changed to$122.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.29 changed to 2.31
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$127.26changed to$126.21
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$127.27changed to$127.26
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.21 changed to 2.24
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$126.98changed to$127.27
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.08 changed to 2.21
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$127.34changed to$126.98
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$127.20changed to$127.34
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$123.95changed to$127.20
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.01 changed to 2.09
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$123.31changed to$123.95
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.00 changed to 2.01
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$123.61changed to$123.31
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.05 changed to 0.06
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$123.00changed to$123.61
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$124.00changed to$123.00
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.10 changed to 0.05
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$124.29changed to$124.00
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.19 changed to 2.00
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $124.29
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $126.37 | $61.24 | RVU26D |
| 2026-07-01 | $126.37 | $61.24 | RVU26C |
| 2026-04-01 | $126.37 | $61.24 | RVU26B |
| 2026-01-01 | $126.37 | $61.24 | RVU26A |
| 2025-10-01 | $120.18 | $71.33 | RVU25D |
| 2025-07-01 | $120.18 | $71.33 | RVU25C |
| 2025-04-01 | $120.18 | $71.33 | RVU25B |
| 2025-01-01 | $120.18 | $71.33 | RVU25A |
| 2024-10-01 | $124.67 | $73.41 | RVU24D |
| 2024-07-01 | $124.67 | $73.41 | RVU24C |
| 2024-04-01 | $124.67 | $73.41 | RVU24B |
| 2024-03-09 | $124.67 | $73.41 | RVU24AR |
| 2024-01-01 | $122.64 | $72.21 | RVU24A |
| 2023-10-01 | $126.21 | $75.05 | RVU23D |
| 2023-07-01 | $126.21 | $75.05 | RVU23C |
| 2023-04-01 | $126.21 | $75.05 | RVU23B |
| 2023-01-01 | $126.21 | $75.05 | RVU23A |
| 2022-10-01 | $127.26 | $76.04 | RVU22D |
| 2022-07-01 | $127.26 | $76.04 | RVU22C |
| 2022-04-01 | $127.26 | $76.04 | RVU22B |
| 2022-01-01 | $127.26 | $76.04 | RVU22A |
| 2021-10-01 | $127.27 | $76.67 | RVU21D |
| 2021-07-01 | $127.27 | $76.67 | RVU21C |
| 2021-04-01 | $127.27 | $76.67 | RVU21B |
| 2021-01-01 | $127.27 | $76.67 | RVU21A |
| 2020-10-01 | $126.98 | $79.34 | RVU20D |
| 2020-07-01 | $126.98 | $79.34 | RVU20C |
| 2020-04-01 | $126.98 | $79.34 | RVU20B |
| 2020-01-01 | $126.98 | $79.34 | RVU20A |
| 2019-10-01 | $127.34 | $79.77 | RVU19D |
| 2019-07-01 | $127.34 | $79.77 | RVU19C |
| 2019-04-01 | $127.34 | $79.77 | RVU19B |
| 2019-01-01 | $127.34 | $79.77 | RVU19A |
| 2018-10-01 | $127.20 | $80.04 | RVU18D |
| 2018-07-01 | $127.20 | $80.04 | RVU18C |
| 2018-04-01 | $127.20 | $80.04 | RVU18B |
| 2018-01-01 | $127.20 | $80.04 | RVU18AR1 |
| 2017-10-01 | $123.95 | $80.16 | RVU17D |
| 2017-07-01 | $123.95 | $80.16 | RVU17C |
| 2017-04-01 | $123.95 | $80.16 | RVU17B |
| 2017-01-01 | $123.95 | $80.16 | RVU17A |
| 2016-10-01 | $123.31 | $79.63 | RVU16D |
| 2016-07-01 | $123.31 | $79.63 | RVU16C |
| 2016-04-01 | $123.31 | $79.63 | RVU16B |
| 2016-01-01 | $123.31 | $79.63 | RVU16A |
| 2015-10-01 | $123.61 | $79.77 | RVU15D |
| 2015-07-01 | $123.61 | $79.77 | RVU15C |
| 2015-04-01 | $123.00 | $79.38 | RVU15B |
| 2015-01-01 | $123.00 | $79.38 | RVU15A |
| 2014-10-01 | $124.00 | $80.66 | RVU14D |
| 2014-07-01 | $124.00 | $80.66 | RVU14C |
| 2014-04-01 | $124.00 | $80.66 | RVU14B |
| 2014-01-01 | $124.00 | $80.66 | RVU14A |
| 2013-10-01 | $124.29 | $78.36 | RVU13D |
| 2013-07-01 | $124.29 | $78.36 | RVU13C |
| 2013-04-01 | $124.29 | $78.36 | RVU13B |
| 2013-01-01 | $124.29 | $78.36 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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