Billing code 92265: Ocular muscle EMGMedicare rate & RVUs

Needle oculoelectromyography records electrical activity in one or more extraocular muscles to investigate suspected muscle or nerve-related eye movement problems.

CMS RVU26DEffective Oct 1, 2026109 payment localities32 Medicare services in 2024

Medicare pays $88.18 for 92265 nationally in the office. Local office rates run $79.24–$117.79.

Medicare rate · 92265

Ocular muscle EMG

Swap in your local Medicare rate.

Work RVUs
0.79
Total RVUs
2.64
Global days
XXX

National rate · 2026

$88.18

Office setting, before claim adjustments.

See every locality for 92265 → · 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 92265 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 92265 covers

An ophthalmologist or other qualified eye-care professional inserts a needle electrode into one or more extraocular muscles and records their electrical activity. The test can help evaluate selected cases of strabismus, diplopia, or suspected extraocular muscle or nerve dysfunction. It is a targeted muscle study, not a retinal test or a photograph of eye movement.

Report the service when needle recording and interpretation of extraocular muscle activity are performed; document the clinical question, muscles tested, findings, and interpretation. The code covers one or more muscles and is priced as bilateral, so modifier 50 does not increase payment. The test has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no component modifier reports the global service. The ophthalmology diagnostic multiple procedure reduction applies to the technical component.

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 92265 pays more and less

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

109 payment localities

$79.24 to $117.79

$79.24$98.52$117.79
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

92265 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$80.25Unavailable
Alaska*$105.04Unavailable
Arizona$86.19Unavailable
Arkansas$79.24Unavailable
Atlanta$89.37Unavailable
Austin$91.70Unavailable
Bakersfield$94.29Unavailable
Baltimore/Surr. Cntys$93.22Unavailable
Beaumont$82.63Unavailable
Brazoria$87.69Unavailable

92265 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.

$79.24

$105.99

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

View every state and territory as a table
92265 office rate range by state
State / territoryOffice rate rangeLocalities
AK$105.041
AL$80.251
AR$79.241
AZ$86.191
CA$94.18–$117.7929
CO$92.261
CT$93.551
DC$100.561
DE$87.511
FL$85.82–$91.713
GA$81.71–$89.372
GU$96.271
HI$96.271
IA$82.581
ID$82.941
IL$83.24–$90.534
IN$83.371
KS$81.981
KY$81.341
LA$81.12–$84.662
MA$91.70–$101.042
MD$89.12–$100.563
ME$83.04–$87.382
MI$82.95–$86.502
MN$89.481
MO$79.73–$85.253
MS$79.511
MT$88.181
NC$83.841
ND$87.781
NE$83.061
NH$90.601
NJ$94.92–$99.672
NM$83.241
NV$88.131
NY$84.92–$101.995
OH$82.871
OK$81.491
OR$87.74–$95.212
PA$83.13–$91.292
PR$88.841
RI$90.621
SC$83.431
SD$87.731
TN$82.311
TX$82.63–$91.708
UT$84.441
VA$86.94–$100.562
VI$88.841
VT$87.241
WA$91.60–$103.252
WI$85.151
WV$80.461
WY$88.001

How the 92265 rate is calculated

Each of 92265’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 · 92265

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.79Practice expense 1.83Malpractice 0.02

2.6400 adjusted RVUs×$33.4009 conversion factor=$88.18

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

Payment rules and modifiers for 92265

The CMS indicators that decide how 92265 is paid alongside other services.

CMS payment indicators · 92265

Ocular muscle EMG

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures7Diagnostic ophthalmology reduction applies to the technical component.
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/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

92265 without 26 · national office

$88.18

Ocular muscle EMG

92265-26 · Professional component

$45.09

Pays only the interpretation and report.

When to use modifier 26

92265 compared with similar codes

Compare codes

92265 vs 92270 vs 92273 vs 92060: national Medicare rates

Swap in your local Medicare rate.

  • 92265
    Ocular muscle EMG · 0.79 wRVU
    $88.18
  • 92270
    Electro-oculography · 0.79 wRVU
    $125.92+$37.74
  • 92273
    Full-field ERG · 0.67 wRVU
    $123.25+$35.07
  • 92060
    Eye alignment test · 0.67 wRVU
    $64.13−$24.05

How to choose

92270Electro-oculography
Choose 92265 for needle recording of extraocular muscle activity. Code 92270 is electro-oculography, a different electrical test rather than a needle muscle study.
92273Full-field ERG
Code 92273 evaluates retinal electrical responses with full-field electroretinography; 92265 evaluates electrical activity in extraocular muscles.
92060Eye alignment test
Code 92060 reports sensorimotor measurements of ocular alignment and movement. It does not represent needle recording of extraocular muscle activity.

92265 billing questions

Does the code count each extraocular muscle separately?

The service covers one or more extraocular muscles, rather than assigning a separate code for each muscle. Document the muscles tested and the findings.

Should modifier 50 be used when both eyes are evaluated?

No. CMS prices this code as bilateral, and modifier 50 does not increase payment.

When should modifier 26 or TC be reported?

Use modifier 26 for the professional interpretation or TC for the technical service involving equipment and staff. Without either modifier, the code represents the global service.

Does the multiple procedure reduction affect the entire service?

The ophthalmology diagnostic multiple procedure reduction applies to the technical component. It does not apply to the professional component under the CMS rule provided for this code.

How is this different from electro-oculography?

Needle oculoelectromyography records electrical activity in extraocular muscles. Electro-oculography records eye-related electrical potential and is not a needle muscle study.

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 92265PPRRVU2026_Oct_nonQPP.csv, line 11,726 (RVU26D)

Open CMS sourceHow we calculate rates

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