CPT code 92019: Eye examination, limited, under general anesthesia2026 Medicare rate & RVUs in California

A limited ophthalmic examination performed under general anesthesia when a patient cannot complete the needed diagnostic examination while awake.

CMS RVU26DEffective Oct 1, 202629 payment localities229 Medicare services in 2024

CMS doesn’t publish an office rate for 92019 in California.

—Office (non-facility)
$59.93–$68.76Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 92019 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 92019 covers

92019 represents a limited ophthalmic diagnostic examination performed while the patient is under general anesthesia. It is commonly used for young children or patients who cannot cooperate sufficiently for an adequate examination while awake. An ophthalmologist examines the eyes and performs the maneuvers needed to address the clinical question, typically in an anesthesia-supported setting. The code represents the eye examination, not the administration of anesthesia.

Select 92019 when the examination under anesthesia is limited in scope; use 92018 when the documented examination is comprehensive. The distinction is based on the scope of the examination, not its duration or whether one or both eyes are examined. Documentation should explain why general anesthesia was needed and identify the examination performed and findings that support the limited level.

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.

Where 92019 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

92019 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CAUnavailable$60.16
Chico, CAUnavailable$59.93
El Centro, CAUnavailable$59.94
Fresno, CAUnavailable$59.93
Hanford, CAUnavailable$59.93
Los Angeles, CAUnavailable$62.43
Madera, CAUnavailable$59.93
Marin County, CAUnavailable$67.51
Merced, CAUnavailable$59.93
Modesto, CAUnavailable$59.93

How the 92019 rate is calculated

Each of 92019’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 · 92019

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.28

1.28 RVUs× 1.000 GPCI

Practice expense0.42

0.42 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

1.7600

Conversion factor

$33.4009

Medicare rate

$58.79

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

Payment rules and modifiers for 92019

92019 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 92019

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

92019 isn’t priced in this setting.

92019 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 92019

    Eye examination, limited, under general anesthesia1.28 wRVU

    Not priced

  • 92018

    Eye examination, comprehensive, under anesthesia2.44 wRVU

    Not priced

  • 92002

    Eye examination, intermediate, new patient0.88 wRVU

    $84.84

  • 92012

    Eye exam, intermediate, established patient0.92 wRVU

    $90.52

How to choose

92018Eye examinationComprehensive, under anesthesia
Both describe ophthalmic examinations under general anesthesia. Choose 92019 for a limited examination and 92018 when the documented examination is comprehensive.
92002Eye examinationIntermediate, new patient
92002 is an intermediate ophthalmological examination for a new patient performed outside the general-anesthesia examination context. Use 92019 for a limited examination performed under general anesthesia.
92012Eye examIntermediate, established patient
92012 is an intermediate ophthalmological examination for an established patient performed outside the general-anesthesia examination context. Use 92019 for a limited examination performed under general anesthesia.

92019 billing questions

How does 92019 differ from 92018?

92019 is for a limited examination under general anesthesia; 92018 is for a comprehensive examination under general anesthesia. The documented scope of the examination determines which code fits.

Can 92019 be reported for an awake office examination?

No. This code describes an examination performed under general anesthesia; an awake examination is coded from the applicable ophthalmological examination family based on its scope and patient status.

Does 92019 include the anesthesia service?

It represents the ophthalmologist’s examination while the patient is under general anesthesia, not the administration of anesthesia.

Does limited mean a short examination or examination of one eye?

No. The code level reflects the scope of the examination, not its duration or laterality.

What documentation supports reporting 92019?

Document why the patient needed general anesthesia, the examination performed, the findings, and why the examination was limited rather than comprehensive.

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 92019PPRRVU2026_Oct_nonQPP.csv, line 11,665 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 92019 pays in California?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 92019 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet