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CPT code 92065: Orthoptic training, direct patient contact2026 Medicare rate & RVUs in King County, WA

Report 92065 for a directly delivered orthoptic or pleoptic training session with continuing medical direction and evaluation, such as therapy for binocular vision dysfunction.

CMS RVU26DEffective Oct 1, 2026One payment locality19K Medicare services in 2024

In King County, WA, Medicare pays $42.91 for 92065 in the office and $29.39 when it’s performed in a hospital or facility.

$42.91Office (non-facility)
$29.39Hospital or facility
+11.7%vs the national office rate ($38.41)

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.

We’ll open 92065 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 92065 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 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 King County, WA 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. King County, WA pays $42.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

92065 in King County, WA vs other payment areas
  1. King County, WA · this page$42.91
  2. Rest of Washington · Washington$39.43−$3.48
  3. Los Angeles, CA · California$41.99−$0.92
  4. Washington, DC area · District of Columbia$42.37−$0.54
  5. Miami, FL · Florida$39.54−$3.37
  6. Chicago, IL · Illinois$39.08−$3.83
  7. Manhattan, NY · New York$42.52−$0.39

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

Every other payment area

92065 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$50.76$39.02
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

92065 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.

$36.13

$50.76

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

View every state and territory as a table
92065 office rate range by state
State / territoryOffice rate rangeLocalities
AK$50.761
AL$36.391
AR$36.131
AZ$37.901
CA$40.09–$47.4329
CO$39.581
CT$40.101
DC$42.371
DE$38.311
FL$37.92–$39.543
GA$36.85–$38.792
GU$40.331
HI$40.331
IA$36.931
ID$37.031
IL$37.29–$39.244
IN$37.141
KS$36.801
KY$36.711
LA$36.67–$37.572
MA$39.51–$42.242
MD$38.79–$42.373
ME$37.08–$38.152
MI$37.15–$38.112
MN$38.611
MO$36.33–$37.693
MS$36.231
MT$38.411
NC$37.281
ND$38.211
NE$37.051
NH$38.991
NJ$40.75–$42.292
NM$37.231
NV$38.371
NY$37.56–$43.015
OH$37.111
OK$36.731
OR$38.25–$40.362
PA$37.16–$39.512
PR$38.571
RI$39.311
SC$37.221
SD$38.191
TN$36.891
TX$37.03–$39.298
UT$37.481
VA$38.06–$42.372
VI$38.571
VT$38.101
WA$39.43–$42.912
WI$37.551
WV$36.591
WY$38.321

See 92065 in every payment locality

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

Office or facility?

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 92065 in King County, WA
ComponentRVULocality factorAdjusted
Physician work0.69× 1.0500.7245
Practice expense0.45× 1.2270.5522
Malpractice0.01× 0.8170.0082
Total RVUs1.2848
Conversion factor× 33.4009

Office rate, King County, WA$42.91

Office: (0.69 × 1.05 + 0.45 × 1.227 + 0.01 × 0.817) × $33.4009 = $42.91

Facility: (0.69 × 1.05 + 0.12 × 1.227 + 0.01 × 0.817) × $33.4009 = $29.39

Open 92065 in the RVU calculator

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

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 92065

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

Codes related to 92065
CodeHow it relatesOffice range, King County, WA
Same family
92066Orthoptic training, supervised serviceRelated orthoptic training reported when the session is performed under physician or qualified professional supervision.$31.83
Often billed with
92060Eye alignment test, multiple deviation measurementsMay be reported for a separately performed sensorimotor examination alongside a training session.$74.45
92014Comprehensive eye exam, established patientA comprehensive eye examination may occur on the same date when separately performed and documented.$147.20

How 92065 has changed in King County, WA

92065 · Office / nonfacility

$42.91

Effective 2026-10-01

The base rate is $0.13 higher than on 2025-10-01, moving from $42.78 to $42.91 (0.3%).

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

    $42.78changed to$42.91

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $44.02changed to$42.78

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $43.30changed to$44.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $45.59changed to$43.30

    • 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
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $61.73changed to$45.59

    • 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
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $62.66changed to$61.73

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.17 changed to 1.16

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $60.83changed to$62.66

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.10 changed to 1.17
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $60.62changed to$60.83

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.12 changed to 1.10
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $61.38changed to$60.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.14 changed to 1.12

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $61.23changed to$61.38

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $59.84changed to$61.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.11 changed to 1.14
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $60.47changed to$59.84

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.12 changed to 1.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $60.17changed to$60.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $59.81changed to$60.17

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.11 changed to 1.12
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $61.77changed to$59.81

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.24 changed to 1.11
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $61.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$42.91$29.39RVU26D
2026-07-01$42.91$29.39RVU26C
2026-04-01$42.91$29.39RVU26B
2026-01-01$42.91$29.39RVU26A
2025-10-01$42.78$34.10RVU25D
2025-07-01$42.78$34.10RVU25C
2025-04-01$42.78$34.10RVU25B
2025-01-01$42.78$34.10RVU25A
2024-10-01$44.02$35.90RVU24D
2024-07-01$44.02$35.90RVU24C
2024-04-01$44.02$35.90RVU24B
2024-03-09$44.02$35.90RVU24AR
2024-01-01$43.30$35.31RVU24A
2023-10-01$45.59Not available in this settingRVU23D
2023-07-01$45.59Not available in this settingRVU23C
2023-04-01$45.59Not available in this settingRVU23B
2023-01-01$45.59Not available in this settingRVU23A
2022-10-01$61.73Not available in this settingRVU22D
2022-07-01$61.73Not available in this settingRVU22C
2022-04-01$61.73Not available in this settingRVU22B
2022-01-01$61.73Not available in this settingRVU22A
2021-10-01$62.66Not available in this settingRVU21D
2021-07-01$62.66Not available in this settingRVU21C
2021-04-01$62.66Not available in this settingRVU21B
2021-01-01$62.66Not available in this settingRVU21A
2020-10-01$60.83Not available in this settingRVU20D
2020-07-01$60.83Not available in this settingRVU20C
2020-04-01$60.83Not available in this settingRVU20B
2020-01-01$60.83Not available in this settingRVU20A
2019-10-01$60.62Not available in this settingRVU19D
2019-07-01$60.62Not available in this settingRVU19C
2019-04-01$60.62Not available in this settingRVU19B
2019-01-01$60.62Not available in this settingRVU19A
2018-10-01$61.38Not available in this settingRVU18D
2018-07-01$61.38Not available in this settingRVU18C
2018-04-01$61.38Not available in this settingRVU18B
2018-01-01$61.38Not available in this settingRVU18AR1
2017-10-01$61.23Not available in this settingRVU17D
2017-07-01$61.23Not available in this settingRVU17C
2017-04-01$61.23Not available in this settingRVU17B
2017-01-01$61.23Not available in this settingRVU17A
2016-10-01$59.84Not available in this settingRVU16D
2016-07-01$59.84Not available in this settingRVU16C
2016-04-01$59.84Not available in this settingRVU16B
2016-01-01$59.84Not available in this settingRVU16A
2015-10-01$60.47Not available in this settingRVU15D
2015-07-01$60.47Not available in this settingRVU15C
2015-04-01$60.17Not available in this settingRVU15B
2015-01-01$60.17Not available in this settingRVU15A
2014-10-01$59.81Not available in this settingRVU14D
2014-07-01$59.81Not available in this settingRVU14C
2014-04-01$59.81Not available in this settingRVU14B
2014-01-01$59.81Not available in this settingRVU14A
2013-10-01$61.77Not available in this settingRVU13D
2013-07-01$61.77Not available in this settingRVU13C
2013-04-01$61.77Not available in this settingRVU13B
2013-01-01$61.77Not available in this settingRVU13AR

Price 92065 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 92065 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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
RVUs for 92065PPRRVU2026_Oct_nonQPP.csv, line 11,673 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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