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CPT code 92014: Comprehensive eye exam, established patient2026 Medicare rate & RVUs in Virginia

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 Virginia, Medicare pays $125.53 for 92014 in the office and $61.51 when it’s performed in a hospital or facility.

$125.53Office (non-facility)
$61.51Hospital or facility
−1.4%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 Virginia
  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 Virginia 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. Virginia pays $125.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

92014 in Virginia vs other payment areas
  1. Virginia · this page$125.53
  2. Los Angeles, CA · California$143.12+$17.59
  3. Washington, DC area · District of Columbia$143.94+$18.41
  4. Miami, FL · Florida$132.52+$6.99
  5. Chicago, IL · Illinois$129.71+$4.18
  6. Manhattan, NY · New York$143.79+$18.26
  7. Alaska · Alaska$155.47+$29.94

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

92014 in every other Medicare payment locality
Payment localityOfficeFacility
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

92014 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 92014 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.42× 1.0001.4200
Practice expense2.35× 0.9832.3100
Malpractice0.04× 0.7060.0282
Total RVUs3.7583
Conversion factor× 33.4009

Office rate, Virginia$125.53

Office: (1.42 × 1 + 2.35 × 0.983 + 0.04 × 0.706) × $33.4009 = $125.53

Facility: (1.42 × 1 + 0.4 × 0.983 + 0.04 × 0.706) × $33.4009 = $61.51

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.

Codes related to 92014

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 92014
CodeHow it relatesOffice range, Virginia
Same family
92004Comprehensive eye exam, new patient, one or more visitsComprehensive eye exam for a new patient$147.76
92012Eye exam, intermediate, established patientIntermediate eye exam for an established patient with a narrower scope$89.22
Often billed with
92015RefractionRefraction, often done at the same visit and billed separatelyNo office rate
92083Visual field exam, extended visual field testingExtended visual field testing may accompany a medically indicated glaucoma exam$62.80
92134Retinal OCT, posterior segment, retinaRetinal OCT imaging may accompany exams for diabetic retinal disease or macular degeneration$32.17
Used instead
92018Eye examination, comprehensive, under anesthesiaComplete eye exam performed under general anesthesiaNo office rate
99214Office visit, established patient, moderate complexityOffice E/M visit that may be reported instead of the eye exam code$133.10

How 92014 has changed in Virginia

92014 · Office / nonfacility

$125.53

Effective 2026-10-01

The base rate is $5.96 higher than on 2025-10-01, moving from $119.57 to $125.53 (5.0%).

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

    $119.57changed to$125.53

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.28 changed to 2.35
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $124.03changed to$119.57

    • 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

    $122.01changed to$124.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $126.07changed to$122.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.29 changed to 2.31
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $127.82changed to$126.07

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $127.84changed to$127.82

    • 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

    $127.27changed to$127.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.08 changed to 2.21
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $127.41changed to$127.27

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $127.27changed to$127.41

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $123.88changed to$127.27

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.01 changed to 2.09
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $123.00changed to$123.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.00 changed to 2.01
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $123.15changed to$123.00

    • 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

    $122.54changed to$123.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $123.87changed to$122.54

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.10 changed to 0.05
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $123.60changed to$123.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.19 changed to 2.00
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $123.60

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$125.53$61.51RVU26D
2026-07-01$125.53$61.51RVU26C
2026-04-01$125.53$61.51RVU26B
2026-01-01$125.53$61.51RVU26A
2025-10-01$119.57$71.51RVU25D
2025-07-01$119.57$71.51RVU25C
2025-04-01$119.57$71.51RVU25B
2025-01-01$119.57$71.51RVU25A
2024-10-01$124.03$73.59RVU24D
2024-07-01$124.03$73.59RVU24C
2024-04-01$124.03$73.59RVU24B
2024-03-09$124.03$73.59RVU24AR
2024-01-01$122.01$72.39RVU24A
2023-10-01$126.07$75.41RVU23D
2023-07-01$126.07$75.41RVU23C
2023-04-01$126.07$75.41RVU23B
2023-01-01$126.07$75.41RVU23A
2022-10-01$127.82$76.86RVU22D
2022-07-01$127.82$76.86RVU22C
2022-04-01$127.82$76.86RVU22B
2022-01-01$127.82$76.86RVU22A
2021-10-01$127.84$77.50RVU21D
2021-07-01$127.84$77.50RVU21C
2021-04-01$127.84$77.50RVU21B
2021-01-01$127.84$77.50RVU21A
2020-10-01$127.27$80.06RVU20D
2020-07-01$127.27$80.06RVU20C
2020-04-01$127.27$80.06RVU20B
2020-01-01$127.27$80.06RVU20A
2019-10-01$127.41$80.50RVU19D
2019-07-01$127.41$80.50RVU19C
2019-04-01$127.41$80.50RVU19B
2019-01-01$127.41$80.50RVU19A
2018-10-01$127.27$80.77RVU18D
2018-07-01$127.27$80.77RVU18C
2018-04-01$127.27$80.77RVU18B
2018-01-01$127.27$80.77RVU18AR1
2017-10-01$123.88$80.75RVU17D
2017-07-01$123.88$80.75RVU17C
2017-04-01$123.88$80.75RVU17B
2017-01-01$123.88$80.75RVU17A
2016-10-01$123.00$80.06RVU16D
2016-07-01$123.00$80.06RVU16C
2016-04-01$123.00$80.06RVU16B
2016-01-01$123.00$80.06RVU16A
2015-10-01$123.15$80.06RVU15D
2015-07-01$123.15$80.06RVU15C
2015-04-01$122.54$79.66RVU15B
2015-01-01$122.54$79.66RVU15A
2014-10-01$123.87$81.39RVU14D
2014-07-01$123.87$81.39RVU14C
2014-04-01$123.87$81.39RVU14B
2014-01-01$123.87$81.39RVU14A
2013-10-01$123.60$78.72RVU13D
2013-07-01$123.60$78.72RVU13C
2013-04-01$123.60$78.72RVU13B
2013-01-01$123.60$78.72RVU13AR

Price 92014 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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