$29.35–$43.16
92133 is for optic nerve and nerve fiber layer analysis, typically for glaucoma; 92134 is for retinal and macular analysis, such as macular degeneration or diabetic edema. They are not reported together at the same encounter.
On this page
CMS RVU26D · Effective 2026-10-01
92133 Optic nerve OCT Medicare reimbursement rates
Scanning laser or OCT imaging of the optic nerve head and retinal nerve fiber layer, reported mainly for glaucoma diagnosis and monitoring. Compare 92133 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92133?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$27.58–$40.38
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $12.80 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 92133 pays more and less
109 payment localities
$27.58 to $40.38
Ophthalmic diagnostic imaging
About 92133: Optic nerve scanning imaging with interpretation
Scanning laser or OCT imaging of the optic nerve head and retinal nerve fiber layer, reported mainly for glaucoma diagnosis and monitoring.
This test uses computerized scanning, most often optical coherence tomography, to assess the optic nerve head and retinal nerve fiber layer thickness; it may also assess macular ganglion cells. Ophthalmologists and optometrists use it in office and hospital outpatient eye clinics for glaucoma suspects, established glaucoma, ocular hypertension, and optic neuropathies. A technician captures the scans, and the interpreting clinician evaluates their quality and findings, comparing results with prior studies when available.
Report one unit whether one or both eyes are scanned. The code is already priced as bilateral, so modifier 50 does not increase payment. Document an interpretation and report with findings relevant to the optic nerve assessment. Billing without a modifier represents the global service; append modifier 26 when billing only the interpretation or TC when billing only equipment and staff services. When multiple eligible ophthalmic diagnostic tests are performed, Medicare's ophthalmic diagnostic multiple procedure reduction affects lower-valued technical components, not the professional interpretations. Use a different code when retinal or macular imaging is the clinical focus.
CMS billing rules for 92133
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Ophthalmology diagnostic multiple procedure reduction applies to the technical component.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.30 · 33%
- Practice expense (office) RVU0.60 · 65%
- Malpractice RVU0.02 · 2%
2.8M
Medicare services in 2024 · #63 by national volume
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.
92133 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$54.05–$78.73
92137 is retinal imaging that includes OCT angiography of retinal vasculature; 92133 assesses optic nerve structure without angiography.
$26.62–$39.16
92132 images the anterior segment, such as the angle or cornea; 92133 images the optic nerve in the posterior segment.
$33.45–$48.53
92250 is fundus photography producing images of the retina and disc; 92133 provides quantitative scanning measurements of nerve fiber layer thickness.
See how rates vary across the country
92133 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$27.58
$36.74
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $36.74 | 1 |
| AL | $27.93 | 1 |
| AR | $27.58 | 1 |
| AZ | $30.01 | 1 |
| CA | $32.51–$40.38 | 29 |
| CO | $31.99 | 1 |
| CT | $32.61 | 1 |
| DC | $34.91 | 1 |
| DE | $30.47 | 1 |
| FL | $30.18–$32.57 | 3 |
| GA | $28.69–$31.21 | 2 |
| GU | $33.19 | 1 |
| HI | $33.19 | 1 |
| IA | $28.62 | 1 |
| ID | $28.77 | 1 |
| IL | $29.36–$31.86 | 4 |
| IN | $28.92 | 1 |
| KS | $28.47 | 1 |
| KY | $28.45 | 1 |
| LA | $28.40–$29.64 | 2 |
| MA | $31.82–$34.95 | 2 |
| MD | $31.01–$34.91 | 3 |
| ME | $28.87–$30.30 | 2 |
| MI | $29.07–$30.49 | 2 |
| MN | $30.84 | 1 |
| MO | $27.95–$29.77 | 3 |
| MS | $27.77 | 1 |
| MT | $30.73 | 1 |
| NC | $29.14 | 1 |
| ND | $30.33 | 1 |
| NE | $28.77 | 1 |
| NH | $31.47 | 1 |
| NJ | $33.04–$34.61 | 2 |
| NM | $29.20 | 1 |
| NV | $30.64 | 1 |
| NY | $29.53–$35.73 | 5 |
| OH | $28.99 | 1 |
| OK | $28.44 | 1 |
| OR | $30.45–$32.94 | 2 |
| PA | $29.05–$31.86 | 2 |
| PR | $30.94 | 1 |
| RI | $31.51 | 1 |
| SC | $29.11 | 1 |
| SD | $30.29 | 1 |
| TN | $28.60 | 1 |
| TX | $28.88–$31.84 | 8 |
| UT | $29.46 | 1 |
| VA | $30.19–$34.91 | 2 |
| VI | $30.94 | 1 |
| VT | $30.20 | 1 |
| WA | $31.76–$35.66 | 2 |
| WI | $29.42 | 1 |
| WV | $28.39 | 1 |
| WY | $30.56 | 1 |
Compare 92133 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $27.93 | Facility Unavailable |
| Alaska* | Office $36.74 | Facility Unavailable |
| Arizona | Office $30.01 | Facility Unavailable |
| Arkansas | Office $27.58 | Facility Unavailable |
| Atlanta | Office $31.21 | Facility Unavailable |
| Austin | Office $31.84 | Facility Unavailable |
| Bakersfield | Office $32.58 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $32.51 | Facility Unavailable |
| Beaumont | Office $28.88 | Facility Unavailable |
| Brazoria | Office $30.48 | Facility Unavailable |
| Chicago | Office $31.76 | Facility Unavailable |
| Chico | Office $32.51 | Facility Unavailable |
| Colorado | Office $31.99 | Facility Unavailable |
| Connecticut | Office $32.61 | Facility Unavailable |
| Dallas | Office $30.64 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $34.91 | Facility Unavailable |
| Delaware | Office $30.47 | Facility Unavailable |
| Detroit | Office $30.49 | Facility Unavailable |
| East St. Louis | Office $29.80 | Facility Unavailable |
| El Centro | Office $32.52 | Facility Unavailable |
| Fort Lauderdale | Office $31.53 | Facility Unavailable |
| Fort Worth | Office $30.45 | Facility Unavailable |
| Fresno | Office $32.51 | Facility Unavailable |
| Galveston | Office $30.55 | Facility Unavailable |
| Hanford-Corcoran | Office $32.51 | Facility Unavailable |
| Hawaii, Guam | Office $33.19 | Facility Unavailable |
| Houston | Office $30.92 | Facility Unavailable |
| Idaho | Office $28.77 | Facility Unavailable |
| Indiana | Office $28.92 | Facility Unavailable |
| Iowa | Office $28.62 | Facility Unavailable |
| Kansas | Office $28.47 | Facility Unavailable |
| Kentucky | Office $28.45 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $34.58 | Facility Unavailable |
| Madera | Office $32.51 | Facility Unavailable |
| Manhattan | Office $35.01 | Facility Unavailable |
| Merced | Office $32.51 | Facility Unavailable |
| Metropolitan Boston | Office $34.95 | Facility Unavailable |
| Metropolitan Kansas City | Office $29.49 | Facility Unavailable |
| Metropolitan Philadelphia | Office $31.86 | Facility Unavailable |
| Metropolitan St. Louis | Office $29.77 | Facility Unavailable |
| Miami | Office $32.57 | Facility Unavailable |
| Minnesota | Office $30.84 | Facility Unavailable |
| Mississippi | Office $27.77 | Facility Unavailable |
| Modesto | Office $32.51 | Facility Unavailable |
| Montana** | Office $30.73 | Facility Unavailable |
| Napa | Office $37.40 | Facility Unavailable |
| Nebraska | Office $28.77 | Facility Unavailable |
| Nevada** | Office $30.64 | Facility Unavailable |
| New Hampshire | Office $31.47 | Facility Unavailable |
| New Mexico | Office $29.20 | Facility Unavailable |
| New Orleans | Office $29.64 | Facility Unavailable |
| North Carolina | Office $29.14 | Facility Unavailable |
| North Dakota** | Office $30.33 | Facility Unavailable |
| Northern Nj | Office $34.61 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $35.73 | Facility Unavailable |
| Ohio | Office $28.99 | Facility Unavailable |
| Oklahoma | Office $28.44 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $34.40 | Facility Unavailable |
| Portland | Office $32.94 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $33.22 | Facility Unavailable |
| Puerto Rico | Office $30.94 | Facility Unavailable |
| Queens | Office $35.31 | Facility Unavailable |
| Redding | Office $32.51 | Facility Unavailable |
| Rest Of California | Office $32.51 | Facility Unavailable |
| Rest Of Florida | Office $30.18 | Facility Unavailable |
| Rest Of Georgia | Office $28.69 | Facility Unavailable |
| Rest Of Illinois | Office $29.36 | Facility Unavailable |
| Rest Of Louisiana | Office $28.40 | Facility Unavailable |
| Rest Of Maine | Office $28.87 | Facility Unavailable |
| Rest Of Maryland | Office $31.01 | Facility Unavailable |
| Rest Of Massachusetts | Office $31.82 | Facility Unavailable |
| Rest Of Michigan | Office $29.07 | Facility Unavailable |
| Rest Of Missouri | Office $27.95 | Facility Unavailable |
| Rest Of New Jersey | Office $33.04 | Facility Unavailable |
| Rest Of New York | Office $29.53 | Facility Unavailable |
| Rest Of Oregon | Office $30.45 | Facility Unavailable |
| Rest Of Pennsylvania | Office $29.05 | Facility Unavailable |
| Rest Of Texas | Office $29.64 | Facility Unavailable |
| Rest Of Washington | Office $31.76 | Facility Unavailable |
| Rhode Island | Office $31.51 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $32.73 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $34.05 | Facility Unavailable |
| Salinas | Office $33.92 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $34.65 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $39.54 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $39.51 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $40.38 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $40.29 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $33.37 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $34.94 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $34.03 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $35.29 | Facility Unavailable |
| Seattle (King Cnty) | Office $35.66 | Facility Unavailable |
| South Carolina | Office $29.11 | Facility Unavailable |
| South Dakota** | Office $30.29 | Facility Unavailable |
| Southern Maine | Office $30.30 | Facility Unavailable |
| Stockton | Office $32.51 | Facility Unavailable |
| Suburban Chicago | Office $31.86 | Facility Unavailable |
| Tennessee | Office $28.60 | Facility Unavailable |
| Utah | Office $29.46 | Facility Unavailable |
| Vallejo | Office $37.37 | Facility Unavailable |
| Vermont | Office $30.20 | Facility Unavailable |
| Virgin Islands | Office $30.94 | Facility Unavailable |
| Virginia | Office $30.19 | Facility Unavailable |
| Visalia | Office $32.51 | Facility Unavailable |
| West Virginia | Office $28.39 | Facility Unavailable |
| Wisconsin | Office $29.42 | Facility Unavailable |
| Wyoming** | Office $30.56 | Facility Unavailable |
| Yuba City | Office $32.51 | Facility Unavailable |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
92133 billing questions
Should one unit or two be billed when both eyes are scanned?
Bill one unit. The code covers unilateral or bilateral imaging, and because it is priced as bilateral, modifier 50 or a second unit does not add payment.
Can optic nerve OCT and retina OCT be billed on the same day?
CPT instructs that 92133 and 92134 are not reported together at the same patient encounter. Choose the code matching the structure that was the clinical focus, such as optic nerve for glaucoma or macula for diabetic macular edema.
When is modifier 26 or TC appended?
Use 26 when billing only the interpretation and TC when billing only the equipment and staff portion. A practice that provides both portions bills the global code without a modifier.
Does the multiple procedure reduction affect 92133 when visual fields are done the same day?
Medicare's ophthalmic diagnostic multiple procedure reduction applies to lower-valued technical components when multiple eligible tests, such as 92133 and 92083, are performed. It does not reduce their professional components.
What documentation supports the interpretation?
Document a written interpretation of scan quality and relevant optic nerve or nerve fiber layer findings, with comparison to prior scans when available. An image printout alone does not establish the professional interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,68792132,,Cptrzd oph dx img ant sgm,A,,0.28,0.59,,0.59,NA,0.02,0.89,0.89,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,1.93,1.93,0.05
11,68892132,26,Cptrzd oph dx img ant sgm,A,,0.28,0.17,,0.17,,0.01,0.46,0.46,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,68992132,TC,Cptrzd oph dx img ant sgm,A,,0.00,0.42,,0.42,NA,0.01,0.43,0.43,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,1.76,1.76,0.04
11,69092133,,Cptrzd oph dx img pst sgm on,A,,0.30,0.60,,0.60,NA,0.02,0.92,0.92,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,1.94,1.94,0.05
11,69192133,26,Cptrzd oph dx img pst sgm on,A,,0.30,0.18,,0.18,,0.01,0.49,0.49,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,69292133,TC,Cptrzd oph dx img pst sgm on,A,,0.00,0.42,,0.42,NA,0.01,0.43,0.43,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,1.76,1.76,0.04
11,69392134,,Cptrz oph dx img pst sgm rta,A,,0.31,0.65,,0.65,NA,0.02,0.98,0.98,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,1.97,1.97,0.05