CPT code 92134: Retinal OCT, posterior segment, retina2026 Medicare rate & RVUs

Medicare pays $32.73 for 92134 nationally in the office. Local office rates run $29.35–$43.16.

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

What 92134 covers

This service uses computerized scanning imaging of the posterior retina, most often optical coherence tomography (OCT) of the macula. Ophthalmologists and optometrists use it to assess retinal thickness and layers in age-related macular degeneration, diabetic macular edema, retinal vein occlusion, macular holes, epiretinal membranes, and vitreomacular traction; OCT also supports hydroxychloroquine toxicity screening. A technician obtains the images in an eye care office or clinic, and the interpreting clinician documents retinal findings. Imaging directed at the optic nerve rather than the retina belongs to 92133.

Report one unit for one or both eyes at a session; CMS prices the code as bilateral, and modifier 50 does not increase payment. The report should identify the eyes examined, clinically relevant findings, and comparison with prior imaging when available. Modifier 26 identifies interpretation alone; modifier TC identifies equipment and staff services alone. Bill globally without either modifier when the billing entity furnishes both components. When multiple eligible ophthalmic diagnostic tests are performed, CMS's ophthalmology diagnostic multiple procedure reduction affects the technical component. Choose 92137 instead when documented OCT angiography is part of the retinal study.

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 92134 pays more and less

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

109 of 109 payment localities

92134 rates by state

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

How the 92134 rate is calculated

Each of 92134’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.

Payment rules and modifiers for 92134

The CMS indicators that decide how 92134 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

92134 compared with similar codes

How to choose

92133Optic nerve OCTPosterior segment, optic nerve

92133 images the optic nerve head and nerve fiber layer for glaucoma or optic neuropathy; 92134 images the retina and macula. Select according to the documented imaging target.

92137OCT angiographyPosterior segment retinal imaging

92137 addresses retinal imaging with OCT angiography; report 92134 when the retinal study consists of structural scanning imaging without OCT angiography.

92250Fundus photographyRetinal photos with interpretation

92250 produces fundus photographs of the retina, while 92134 produces cross-sectional scanning images used to assess retinal layers and thickness.

Codes related to 92134

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

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

Open CMS sourceHow we calculate rates