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Billing code 92018: Eye examinationMedicare rate & RVUs

A comprehensive ophthalmic assessment performed under general anesthesia when a complete, reliable examination cannot be obtained while the patient is awake.

CMS RVU26DEffective Oct 1, 2026109 payment localities741 Medicare services in 2024

Medicare pays $113.23 for 92018 nationally in a facility.

Medicare rate · 92018

Eye examination

Swap in your local Medicare rate.

Work RVUs
2.44
Total RVUs
3.39
Global days
XXX

National rate · 2026

$113.23

Facility setting, before claim adjustments.

See every locality for 92018 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 92018 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 92018 covers

An ophthalmologist performs a full diagnostic eye assessment while the patient is under general anesthesia, allowing evaluation when a reliable examination cannot be completed awake. Common situations include a young child or a patient with significant developmental, behavioral, or physical limitations. The examination may take place in an operating room or another anesthesia-capable setting, and may include manipulation of the globe when needed for diagnostic or therapeutic purposes. This service is broader than a limited anesthetized eye examination.

Select 92018 when the documented ophthalmic work is comprehensive rather than a targeted check of one problem. Record why anesthesia was needed, which examination elements were completed, the findings, and any manipulation or treatment performed. The anesthesia setting alone does not establish the comprehensive level; the scope of the eye examination does. Document the service as a comprehensive assessment rather than splitting its routine examination observations among separate eye-exam codes. A limited examination under anesthesia is reported with 92019.

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 92018 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

92018 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$108.13
Alaska*Unavailable$154.15
ArizonaUnavailable$111.83
ArkansasUnavailable$107.49
AtlantaUnavailable$114.66
AustinUnavailable$114.60
BakersfieldUnavailable$116.03
Baltimore/Surr. CntysUnavailable$117.45
BeaumontUnavailable$110.44
BrazoriaUnavailable$112.82

92018 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
92018 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 92018 rate is calculated

Each of 92018’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 · 92018

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.44Practice expense 0.84Malpractice 0.11

3.3900 adjusted RVUs×$33.4009 conversion factor=$113.23

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 92018

92018 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 · 92018

Which rate does Medicare pay?

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

Non-facility (office) rate · national

—

92018 isn’t priced in this setting.

92018 compared with similar codes

Compare codes

92018 vs 92019 vs 92004 vs 92014: national Medicare rates

Swap in your local Medicare rate.

  • 92018
    Eye examination · 2.44 wRVU
    —
  • 92019
    Eye examination · 1.28 wRVU
    —
  • 92004
    Comprehensive eye exam · 1.82 wRVU
    $149.64
  • 92014
    Comprehensive eye exam · 1.42 wRVU
    $127.26

How to choose

92019Eye examination
Both describe an ophthalmic examination under general anesthesia. Choose 92018 for comprehensive work and 92019 for a limited examination.
92004Comprehensive eye exam
92004 is a comprehensive eye examination for a new patient who can be examined without general anesthesia; 92018 is selected for a comprehensive assessment performed under anesthesia.
92014Comprehensive eye exam
92014 is the comprehensive eye examination for an established patient examined without general anesthesia. 92018 is distinguished by the comprehensive examination under anesthesia.

Codes related to 92018

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

Codes related to 92018
CodeHow it relatesNational office range
Same family
92019Eye examinationLimited-scope ophthalmic examination performed under general anesthesia.No office rate
Used instead
92004Comprehensive eye examComprehensive new-patient eye examination when the patient can be examined without anesthesia.$136.65–$194.38
92014Comprehensive eye examComprehensive established-patient eye examination when anesthesia is not needed.$115.54–$166.55

92018 billing questions

When should 92018 be chosen over 92019?

Use 92018 for a comprehensive ophthalmic assessment under anesthesia. Use 92019 when the anesthetized examination is limited in scope.

Does the patient have to be a child?

No. The relevant circumstance is the need for general anesthesia to obtain the documented examination, not the patient's age.

Does 92018 include the anesthesia service?

No. 92018 represents the ophthalmologist's examination; the anesthesia professional's service is separate.

Does general anesthesia itself require a modifier?

General anesthesia alone is not a reason to append a modifier to 92018.

What documentation supports reporting 92018?

Document why an examination while awake was not feasible, the scope of the comprehensive eye assessment, the findings, and any globe manipulation or treatment 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

Show the CMS file lines behind this rate
RVUs for 92018PPRRVU2026_Oct_nonQPP.csv, line 11,664 (RVU26D)

Open CMS sourceHow we calculate rates

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