CPT code 92065: Orthoptic training, direct patient contact2026 Medicare rate & RVUs in Iowa
Report 92065 for a directly delivered orthoptic or pleoptic training session with continuing medical direction and evaluation, such as therapy for binocular vision dysfunction.
In Iowa, Medicare pays $36.93 for 92065 in the office and $26.85 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 92065 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 92065 covers
This service covers a hands-on session of orthoptic or pleoptic training delivered in direct contact with the patient. Ophthalmologists, optometrists, or other qualified health care professionals may perform sessions that address visual function, such as binocular coordination or convergence problems. Training may use prescribed eye exercises or other structured activities selected for the patient’s diagnosed condition and treatment goals; it is not simply an eye examination or a recommendation for home exercises.
Report the code for each qualifying session, supported by documentation of the condition treated, the training performed, the patient’s participation and response, and the continuing medical direction and evaluation. The record should distinguish the treatment session from a separately performed assessment, such as a sensorimotor examination. CMS pricing treats this code 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 Iowa compares for 92065
Across 109 of 109 payment localities, the office rate for 92065 runs from $36.13 in Arkansas to $50.76 in Alaska. Iowa pays $36.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$36.93
- Los Angeles, CA · California$41.99+$5.06
- Washington, DC area · District of Columbia$42.37+$5.44
- Miami, FL · Florida$39.54+$2.61
- Chicago, IL · Illinois$39.08+$2.15
- Manhattan, NY · New York$42.52+$5.59
- Alaska · Alaska$50.76+$13.83
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $36.39 | $26.74 |
| ArkansasArkansas | $36.13 | $26.66 |
| ArizonaArizona | $37.90 | $27.22 |
| Bakersfield, CACalifornia | $40.16 | $28.08 |
| Chico, CACalifornia | $40.09 | $28.01 |
| El Centro, CACalifornia | $40.09 | $28.01 |
| Fresno, CACalifornia | $40.09 | $28.01 |
| Hanford, CACalifornia | $40.09 | $28.01 |
| Madera, CACalifornia | $40.09 | $28.01 |
| Merced, CACalifornia | $40.09 | $28.01 |
| Modesto, CACalifornia | $40.09 | $28.01 |
| Napa, CACalifornia | $44.48 | $29.95 |
| Oxnard, CACalifornia | $41.67 | $28.64 |
| Redding, CACalifornia | $40.09 | $28.01 |
| Rest of CaliforniaCalifornia | $40.09 | $28.01 |
| Riverside, CACalifornia | $40.22 | $28.14 |
| Sacramento, CACalifornia | $41.54 | $28.72 |
| Salinas, CACalifornia | $41.36 | $28.59 |
| San Diego, CACalifornia | $41.90 | $28.71 |
| Marin County, CACalifornia | $46.58 | $31.04 |
| San Francisco, CACalifornia | $46.57 | $31.03 |
| San Benito County, CACalifornia | $47.43 | $31.54 |
| Santa Clara County, CACalifornia | $47.39 | $31.49 |
| San Luis Obispo, CACalifornia | $40.74 | $28.18 |
| Santa Cruz, CACalifornia | $41.97 | $28.58 |
| Santa Maria, CACalifornia | $41.40 | $28.54 |
| Santa Rosa, CACalifornia | $42.37 | $28.84 |
| Stockton, CACalifornia | $40.09 | $28.01 |
| Vallejo, CACalifornia | $44.46 | $29.93 |
| Visalia, CACalifornia | $40.09 | $28.01 |
| Yuba City, CACalifornia | $40.09 | $28.01 |
| ColoradoColorado | $39.58 | $27.85 |
| ConnecticutConnecticut | $40.10 | $28.23 |
| DelawareDelaware | $38.31 | $27.42 |
| Fort Lauderdale, FLFlorida | $38.88 | $27.71 |
| Rest of FloridaFlorida | $37.92 | $27.38 |
| Atlanta, GAGeorgia | $38.79 | $27.59 |
| Rest of GeorgiaGeorgia | $36.85 | $27.02 |
| Hawaii, Guam, HIHawaii | $40.33 | $27.80 |
| IdahoIdaho | $37.03 | $26.89 |
| East St. Louis, ILIllinois | $37.55 | $27.41 |
| Rest of IllinoisIllinois | $37.29 | $27.23 |
| Suburban Chicago, ILIllinois | $39.24 | $27.92 |
| IndianaIndiana | $37.14 | $26.92 |
| KansasKansas | $36.80 | $26.84 |
| KentuckyKentucky | $36.71 | $26.92 |
| New Orleans, LALouisiana | $37.57 | $27.20 |
| Rest of LouisianaLouisiana | $36.67 | $26.91 |
| Metropolitan Boston, MAMassachusetts | $42.24 | $29.07 |
| Rest of MassachusettsMassachusetts | $39.51 | $27.90 |
| Baltimore area, MDMaryland | $39.96 | $28.13 |
| Rest of MarylandMaryland | $38.79 | $27.64 |
| Rest of MaineMaine | $37.08 | $26.94 |
| Southern Maine, MEMaine | $38.15 | $27.23 |
| Detroit, MIMichigan | $38.11 | $27.48 |
| Rest of MichiganMichigan | $37.15 | $27.08 |
| MinnesotaMinnesota | $38.61 | $27.27 |
| Metropolitan Kansas City, MOMissouri | $37.49 | $27.14 |
| Metropolitan St. Louis, MOMissouri | $37.69 | $27.20 |
| Rest of MissouriMissouri | $36.33 | $26.83 |
| MississippiMississippi | $36.23 | $26.74 |
| MontanaMontana | $38.41 | $27.39 |
| North CarolinaNorth Carolina | $37.28 | $27.00 |
| North DakotaNorth Dakota | $38.21 | $27.19 |
| NebraskaNebraska | $37.05 | $26.87 |
| New HampshireNew Hampshire | $38.99 | $27.51 |
| Northern New JerseyNew Jersey | $42.29 | $29.50 |
| Rest of New JerseyNew Jersey | $40.75 | $28.71 |
| New MexicoNew Mexico | $37.23 | $27.12 |
| NevadaNevada | $38.37 | $27.34 |
| NYC suburbs and Long Island, NYNew York | $43.01 | $29.91 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $40.95 | $28.88 |
| Queens, NYNew York | $42.77 | $29.74 |
| Rest of New YorkNew York | $37.56 | $27.09 |
| OhioOhio | $37.11 | $27.04 |
| OklahomaOklahoma | $36.73 | $26.89 |
| Portland, OROregon | $40.36 | $28.12 |
| Rest of OregonOregon | $38.25 | $27.27 |
| Metropolitan Philadelphia, PAPennsylvania | $39.51 | $28.03 |
| Rest of PennsylvaniaPennsylvania | $37.16 | $27.04 |
| Puerto RicoPuerto Rico | $38.57 | $27.43 |
| Rhode IslandRhode Island | $39.31 | $27.92 |
| South CarolinaSouth Carolina | $37.22 | $27.03 |
| South DakotaSouth Dakota | $38.19 | $27.17 |
| TennesseeTennessee | $36.89 | $26.87 |
| Austin, TXTexas | $39.29 | $27.63 |
| Beaumont, TXTexas | $37.03 | $27.00 |
| Brazoria, TXTexas | $38.39 | $27.46 |
| Dallas, TXTexas | $38.51 | $27.53 |
| Fort Worth, TXTexas | $38.36 | $27.50 |
| Galveston, TXTexas | $38.43 | $27.49 |
| Houston, TXTexas | $38.62 | $27.67 |
| Rest of TexasTexas | $37.61 | $27.15 |
| UtahUtah | $37.48 | $27.11 |
| VirginiaVirginia | $38.06 | $27.22 |
| Virgin Islands, VIUnited States Virgin Islands | $38.57 | $27.43 |
| VermontVermont | $38.10 | $27.18 |
| Rest of WashingtonWashington | $39.43 | $27.82 |
| King County, WAWashington | $42.91 | $29.39 |
| WisconsinWisconsin | $37.55 | $26.99 |
| West VirginiaWest Virginia | $36.59 | $27.01 |
| WyomingWyoming | $38.32 | $27.30 |
92065 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.
$36.13
$50.76
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 | $50.76 | 1 |
| AL | $36.39 | 1 |
| AR | $36.13 | 1 |
| AZ | $37.90 | 1 |
| CA | $40.09–$47.43 | 29 |
| CO | $39.58 | 1 |
| CT | $40.10 | 1 |
| DC | $42.37 | 1 |
| DE | $38.31 | 1 |
| FL | $37.92–$39.54 | 3 |
| GA | $36.85–$38.79 | 2 |
| GU | $40.33 | 1 |
| HI | $40.33 | 1 |
| IA | $36.93 | 1 |
| ID | $37.03 | 1 |
| IL | $37.29–$39.24 | 4 |
| IN | $37.14 | 1 |
| KS | $36.80 | 1 |
| KY | $36.71 | 1 |
| LA | $36.67–$37.57 | 2 |
| MA | $39.51–$42.24 | 2 |
| MD | $38.79–$42.37 | 3 |
| ME | $37.08–$38.15 | 2 |
| MI | $37.15–$38.11 | 2 |
| MN | $38.61 | 1 |
| MO | $36.33–$37.69 | 3 |
| MS | $36.23 | 1 |
| MT | $38.41 | 1 |
| NC | $37.28 | 1 |
| ND | $38.21 | 1 |
| NE | $37.05 | 1 |
| NH | $38.99 | 1 |
| NJ | $40.75–$42.29 | 2 |
| NM | $37.23 | 1 |
| NV | $38.37 | 1 |
| NY | $37.56–$43.01 | 5 |
| OH | $37.11 | 1 |
| OK | $36.73 | 1 |
| OR | $38.25–$40.36 | 2 |
| PA | $37.16–$39.51 | 2 |
| PR | $38.57 | 1 |
| RI | $39.31 | 1 |
| SC | $37.22 | 1 |
| SD | $38.19 | 1 |
| TN | $36.89 | 1 |
| TX | $37.03–$39.29 | 8 |
| UT | $37.48 | 1 |
| VA | $38.06–$42.37 | 2 |
| VI | $38.57 | 1 |
| VT | $38.10 | 1 |
| WA | $39.43–$42.91 | 2 |
| WI | $37.55 | 1 |
| WV | $36.59 | 1 |
| WY | $38.32 | 1 |
How the 92065 rate is calculated
Each of 92065’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 · 92065
RVUs × geographic indexes × conversion factor
Work0.69
0.69 RVUs× 1.000 GPCI
Practice expense0.45
0.45 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.1500
Conversion factor
$33.4009
Medicare rate
$38.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,673
- Code
- 92065
- Physician work
- 0.69
- Practice expense
- 0.45
- Malpractice
- 0.01
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.69 | × 1.000 | 0.6900 |
| Practice expense | 0.45 | × 0.915 | 0.4118 |
| Malpractice | 0.01 | × 0.397 | 0.0040 |
| Total RVUs | 1.1057 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$36.93
Office: (0.69 × 1 + 0.45 × 0.915 + 0.01 × 0.397) × $33.4009 = $36.93
Facility: (0.69 × 1 + 0.12 × 0.915 + 0.01 × 0.397) × $33.4009 = $26.85
Payment rules and modifiers for 92065
The CMS indicators that decide how 92065 is paid alongside other services.
CMS payment indicators · 92065
Orthoptic training, direct patient contact
| 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 92065 has changed in Iowa
92065 · Office / nonfacility
$36.93
Effective 2026-10-01
The base rate is $0.06 lower than on 2025-10-01, moving from $36.99 to $36.93 (0.2%).
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
$36.99changed to$36.93
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.71 changed to 0.69
- Practice expense RVU 0.47 changed to 0.45
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$38.07changed to$36.99
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$37.45changed to$38.07
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$39.47changed to$37.45
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.49 changed to 0.47
- Malpractice RVU 0.02 changed to 0.01
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$49.51changed to$39.47
- Conversion factor 34.6062 changed to 33.8872
- Work RVU 0.37 changed to 0.71
- Practice expense RVU 1.16 changed to 0.49
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$50.24changed to$49.51
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.17 changed to 1.16
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$49.67changed to$50.24
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.10 changed to 1.17
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$50.25changed to$49.67
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.12 changed to 1.10
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$50.85changed to$50.25
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.14 changed to 1.12
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$50.51changed to$50.85
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$49.21changed to$50.51
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.11 changed to 1.14
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$49.71changed to$49.21
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.12 changed to 1.11
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$49.46changed to$49.71
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$49.06changed to$49.46
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.11 changed to 1.12
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$50.32changed to$49.06
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.24 changed to 1.11
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $50.32
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $36.93 | $26.85 | RVU26D |
| 2026-07-01 | $36.93 | $26.85 | RVU26C |
| 2026-04-01 | $36.93 | $26.85 | RVU26B |
| 2026-01-01 | $36.93 | $26.85 | RVU26A |
| 2025-10-01 | $36.99 | $30.50 | RVU25D |
| 2025-07-01 | $36.99 | $30.50 | RVU25C |
| 2025-04-01 | $36.99 | $30.50 | RVU25B |
| 2025-01-01 | $36.99 | $30.50 | RVU25A |
| 2024-10-01 | $38.07 | $31.99 | RVU24D |
| 2024-07-01 | $38.07 | $31.99 | RVU24C |
| 2024-04-01 | $38.07 | $31.99 | RVU24B |
| 2024-03-09 | $38.07 | $31.99 | RVU24AR |
| 2024-01-01 | $37.45 | $31.47 | RVU24A |
| 2023-10-01 | $39.47 | Not available in this setting | RVU23D |
| 2023-07-01 | $39.47 | Not available in this setting | RVU23C |
| 2023-04-01 | $39.47 | Not available in this setting | RVU23B |
| 2023-01-01 | $39.47 | Not available in this setting | RVU23A |
| 2022-10-01 | $49.51 | Not available in this setting | RVU22D |
| 2022-07-01 | $49.51 | Not available in this setting | RVU22C |
| 2022-04-01 | $49.51 | Not available in this setting | RVU22B |
| 2022-01-01 | $49.51 | Not available in this setting | RVU22A |
| 2021-10-01 | $50.24 | Not available in this setting | RVU21D |
| 2021-07-01 | $50.24 | Not available in this setting | RVU21C |
| 2021-04-01 | $50.24 | Not available in this setting | RVU21B |
| 2021-01-01 | $50.24 | Not available in this setting | RVU21A |
| 2020-10-01 | $49.67 | Not available in this setting | RVU20D |
| 2020-07-01 | $49.67 | Not available in this setting | RVU20C |
| 2020-04-01 | $49.67 | Not available in this setting | RVU20B |
| 2020-01-01 | $49.67 | Not available in this setting | RVU20A |
| 2019-10-01 | $50.25 | Not available in this setting | RVU19D |
| 2019-07-01 | $50.25 | Not available in this setting | RVU19C |
| 2019-04-01 | $50.25 | Not available in this setting | RVU19B |
| 2019-01-01 | $50.25 | Not available in this setting | RVU19A |
| 2018-10-01 | $50.85 | Not available in this setting | RVU18D |
| 2018-07-01 | $50.85 | Not available in this setting | RVU18C |
| 2018-04-01 | $50.85 | Not available in this setting | RVU18B |
| 2018-01-01 | $50.85 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $50.51 | Not available in this setting | RVU17D |
| 2017-07-01 | $50.51 | Not available in this setting | RVU17C |
| 2017-04-01 | $50.51 | Not available in this setting | RVU17B |
| 2017-01-01 | $50.51 | Not available in this setting | RVU17A |
| 2016-10-01 | $49.21 | Not available in this setting | RVU16D |
| 2016-07-01 | $49.21 | Not available in this setting | RVU16C |
| 2016-04-01 | $49.21 | Not available in this setting | RVU16B |
| 2016-01-01 | $49.21 | Not available in this setting | RVU16A |
| 2015-10-01 | $49.71 | Not available in this setting | RVU15D |
| 2015-07-01 | $49.71 | Not available in this setting | RVU15C |
| 2015-04-01 | $49.46 | Not available in this setting | RVU15B |
| 2015-01-01 | $49.46 | Not available in this setting | RVU15A |
| 2014-10-01 | $49.06 | Not available in this setting | RVU14D |
| 2014-07-01 | $49.06 | Not available in this setting | RVU14C |
| 2014-04-01 | $49.06 | Not available in this setting | RVU14B |
| 2014-01-01 | $49.06 | Not available in this setting | RVU14A |
| 2013-10-01 | $50.32 | Not available in this setting | RVU13D |
| 2013-07-01 | $50.32 | Not available in this setting | RVU13C |
| 2013-04-01 | $50.32 | Not available in this setting | RVU13B |
| 2013-01-01 | $50.32 | Not available in this setting | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
92065 billing questions
How does 92065 differ from 92066?
92065 is for training delivered in direct contact with the patient by a physician or other qualified health care professional. 92066 describes training performed under a physician’s or qualified health care professional’s supervision.
Can 92065 be reported with a sensorimotor examination?
Yes, when a distinct sensorimotor examination is performed and documented in addition to the training session. The examination evaluates alignment or eye movement; the training is the therapeutic service.
Should modifier 50 be appended?
No. CMS pricing already treats 92065 as bilateral, and modifier 50 does not increase payment.
What documentation supports a session?
Document the treated visual condition, the specific training activities, direct patient participation, the response or progress, and the continuing medical direction and evaluation.
Is 92065 reported per hour or per exercise?
The code is reported for each qualifying training session, not separately for each exercise. The record should identify the session and the services delivered.
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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