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CMS RVU26D · Effective 2026-10-01

92012 in Alaska*

Office / nonfacility

$109.25

Base rate per service

Facility setting

$56.96

Base rate per service

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.

Ophthalmology services

About 92012: Intermediate eye exam, established patient

An intermediate ophthalmological exam is reported when an ophthalmologist or optometrist evaluates a defined eye concern in an established patient without performing a comprehensive exam.

An intermediate ophthalmological examination addresses a defined eye concern or interval reassessment in a returning patient. The ophthalmologist or optometrist obtains an interval history, makes general medical observations, examines the external eye and surrounding structures, and performs other diagnostic steps as indicated. The examination may involve one eye or both and may include dilation when needed. The clinician establishes or updates a diagnostic and treatment plan based on the findings. This service is commonly furnished in an office or outpatient eye clinic.

Report 92012 when the patient qualifies as established and the documented examination supports an intermediate rather than comprehensive ophthalmological service. Record the presenting concern, pertinent history, examined structures, findings, and diagnostic and treatment plan. A comprehensive evaluation of the visual system is reported with 92014 instead. Refraction, if performed, is reported separately with 92015. Medically necessary visual field or retinal imaging tests require separate documentation to support reporting them alongside the exam. CMS prices 92012 as bilateral, so examining both eyes does not support two units, and modifier 50 does not increase payment.

CMS billing rules for 92012

Bilateral procedures
The code is already priced as bilateral; modifier 50 does not increase payment.

Where the value comes from

  • Work RVU0.92 · 34%
  • Practice expense (office) RVU1.76 · 65%
  • Malpractice RVU0.03 · 1%

3.2M

Medicare services in 2024 · #58 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.

92012 compared with similar codes

Office rates for Alaska*, from the same CMS release.

92014

Comprehensive eye exam

Established patient

$155.47

92014 covers a comprehensive evaluation of the visual system; 92012 covers an intermediate examination with diagnostic steps indicated by the patient's concern. Select the code supported by the documented scope.

92002

Eye examination

Intermediate, new patient

$102.80

92002 is the intermediate exam for a new patient; 92012 is for a patient who meets the established-patient definition.

99213

Office visit

Established patient, low complexity

$118.72

99213 is an office E/M level selected by medical decision making or qualifying total time; 92012 is an intermediate ophthalmological exam. Do not report both for the same work.

92015

Determine refractive state

No office rate

92015 describes refraction to determine a lens prescription. Report it separately from 92012 when refraction is performed.

The same code, a different location

How does Alaska* compare?

92012 across payment areas

Same release and payment basis · bars start at $0

  1. Alaska* · This locality

    $109.25

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $102.20

    $7.05 lower than Alaska*

  3. Dc + Md/Va Suburbs

    $102.75

    $6.50 lower than Alaska*

  4. Miami

    $94.46

    $14.79 lower than Alaska*

  5. Chicago

    $92.32

    $16.93 lower than Alaska*

  6. Manhattan

    $102.59

    $6.66 lower than Alaska*

  7. Alabama

    $82.73

    $26.52 lower than Alaska*

Other payment areas listed in Alaska appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 92012 ranges from $81.74 in Arkansas to $119.41 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Arkansas

    Arkansas · 92012

    Office

    $81.74

    Facility

    $39.57

    $27.51 lower than Alaska* for the office setting.

  • Arizona

    Arizona · 92012

    Office

    $88.55

    Facility

    $40.97

    $20.70 lower than Alaska* for the office setting.

  • Bakersfield

    California · 92012

    Office

    $96.35

    Facility

    $42.54

    $12.90 lower than Alaska* for the office setting.

  • Chico

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • El Centro

    California · 92012

    Office

    $96.22

    Facility

    $42.41

    $13.03 lower than Alaska* for the office setting.

  • Fresno

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Hanford-Corcoran

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Madera

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Merced

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Modesto

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Napa

    California · 92012

    Office

    $110.65

    Facility

    $45.94

    $1.40 higher than Alaska* for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 92012

    Office

    $101.70

    Facility

    $43.66

    $7.55 lower than Alaska* for the office setting.

  • Redding

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Rest Of California

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 92012

    Office

    $96.57

    Facility

    $42.75

    $12.68 lower than Alaska* for the office setting.

  • Sacramento-Roseville-Folsom

    California · 92012

    Office

    $100.74

    Facility

    $43.64

    $8.51 lower than Alaska* for the office setting.

  • Salinas

    California · 92012

    Office

    $100.35

    Facility

    $43.44

    $8.90 lower than Alaska* for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 92012

    Office

    $102.50

    Facility

    $43.78

    $6.75 lower than Alaska* for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 92012

    Office

    $117.00

    Facility

    $47.77

    $7.75 higher than Alaska* for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 92012

    Office

    $116.96

    Facility

    $47.73

    $7.71 higher than Alaska* for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 92012

    Office

    $119.41

    Facility

    $48.61

    $10.16 higher than Alaska* for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 92012

    Office

    $119.28

    Facility

    $48.47

    $10.03 higher than Alaska* for the office setting.

  • San Luis Obispo-Paso Robles

    California · 92012

    Office

    $98.75

    Facility

    $42.82

    $10.50 lower than Alaska* for the office setting.

  • Santa Cruz-Watsonville

    California · 92012

    Office

    $103.34

    Facility

    $43.68

    $5.91 lower than Alaska* for the office setting.

  • Santa Maria-Santa Barbara

    California · 92012

    Office

    $100.67

    Facility

    $43.42

    $8.58 lower than Alaska* for the office setting.

  • Santa Rosa-Petaluma

    California · 92012

    Office

    $104.38

    Facility

    $44.08

    $4.87 lower than Alaska* for the office setting.

  • Stockton

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Vallejo

    California · 92012

    Office

    $110.60

    Facility

    $45.89

    $1.35 higher than Alaska* for the office setting.

  • Visalia

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Yuba City

    California · 92012

    Office

    $96.22

    Facility

    $42.40

    $13.03 lower than Alaska* for the office setting.

  • Colorado

    Colorado · 92012

    Office

    $94.43

    Facility

    $42.19

    $14.82 lower than Alaska* for the office setting.

  • Connecticut

    Connecticut · 92012

    Office

    $95.87

    Facility

    $42.99

    $13.38 lower than Alaska* for the office setting.

  • Delaware

    Delaware · 92012

    Office

    $89.86

    Facility

    $41.35

    $19.39 lower than Alaska* for the office setting.

  • Fort Lauderdale

    Florida · 92012

    Office

    $92.09

    Facility

    $42.35

    $17.16 lower than Alaska* for the office setting.

  • Rest Of Florida

    Florida · 92012

    Office

    $88.43

    Facility

    $41.49

    $20.82 lower than Alaska* for the office setting.

  • Atlanta

    Georgia · 92012

    Office

    $91.75

    Facility

    $41.87

    $17.50 lower than Alaska* for the office setting.

  • Rest Of Georgia

    Georgia · 92012

    Office

    $84.36

    Facility

    $40.56

    $24.89 lower than Alaska* for the office setting.

  • Hawaii, Guam

    Hawaii · 92012

    Office

    $98.15

    Facility

    $42.32

    $11.10 lower than Alaska* for the office setting.

  • Iowa

    Iowa · 92012

    Office

    $84.92

    Facility

    $39.99

    $24.33 lower than Alaska* for the office setting.

  • Idaho

    Idaho · 92012

    Office

    $85.29

    Facility

    $40.11

    $23.96 lower than Alaska* for the office setting.

  • East St. Louis

    Illinois · 92012

    Office

    $86.83

    Facility

    $41.66

    $22.42 lower than Alaska* for the office setting.

  • Rest Of Illinois

    Illinois · 92012

    Office

    $85.97

    Facility

    $41.14

    $23.28 lower than Alaska* for the office setting.

  • Suburban Chicago

    Illinois · 92012

    Office

    $93.09

    Facility

    $42.67

    $16.16 lower than Alaska* for the office setting.

  • Indiana

    Indiana · 92012

    Office

    $85.71

    Facility

    $40.19

    $23.54 lower than Alaska* for the office setting.

  • Kansas

    Kansas · 92012

    Office

    $84.38

    Facility

    $39.99

    $24.87 lower than Alaska* for the office setting.

  • Kentucky

    Kentucky · 92012

    Office

    $83.91

    Facility

    $40.26

    $25.34 lower than Alaska* for the office setting.

  • New Orleans

    Louisiana · 92012

    Office

    $87.18

    Facility

    $40.98

    $22.07 lower than Alaska* for the office setting.

  • Rest Of Louisiana

    Louisiana · 92012

    Office

    $83.71

    Facility

    $40.26

    $25.54 lower than Alaska* for the office setting.

  • Metropolitan Boston

    Massachusetts · 92012

    Office

    $103.07

    Facility

    $44.45

    $6.18 lower than Alaska* for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 92012

    Office

    $93.92

    Facility

    $42.22

    $15.33 lower than Alaska* for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 92012

    Office

    $95.54

    Facility

    $42.85

    $13.71 lower than Alaska* for the office setting.

  • Rest Of Maryland

    Maryland · 92012

    Office

    $91.45

    Facility

    $41.76

    $17.80 lower than Alaska* for the office setting.

  • Rest Of Maine

    Maine · 92012

    Office

    $85.43

    Facility

    $40.26

    $23.82 lower than Alaska* for the office setting.

  • Southern Maine

    Maine · 92012

    Office

    $89.62

    Facility

    $40.96

    $19.63 lower than Alaska* for the office setting.

  • Detroit

    Michigan · 92012

    Office

    $89.15

    Facility

    $41.77

    $20.10 lower than Alaska* for the office setting.

  • Rest Of Michigan

    Michigan · 92012

    Office

    $85.53

    Facility

    $40.70

    $23.72 lower than Alaska* for the office setting.

  • Minnesota

    Minnesota · 92012

    Office

    $91.52

    Facility

    $40.99

    $17.73 lower than Alaska* for the office setting.

  • Metropolitan Kansas City

    Missouri · 92012

    Office

    $86.91

    Facility

    $40.80

    $22.34 lower than Alaska* for the office setting.

  • Metropolitan St. Louis

    Missouri · 92012

    Office

    $87.70

    Facility

    $40.95

    $21.55 lower than Alaska* for the office setting.

  • Rest Of Missouri

    Missouri · 92012

    Office

    $82.38

    Facility

    $40.05

    $26.87 lower than Alaska* for the office setting.

  • Mississippi

    Mississippi · 92012

    Office

    $82.08

    Facility

    $39.81

    $27.17 lower than Alaska* for the office setting.

  • Montana**

    Montana · 92012

    Office

    $90.51

    Facility

    $41.42

    $18.74 lower than Alaska* for the office setting.

  • North Carolina

    North Carolina · 92012

    Office

    $86.22

    Facility

    $40.41

    $23.03 lower than Alaska* for the office setting.

  • North Dakota**

    North Dakota · 92012

    Office

    $89.92

    Facility

    $40.82

    $19.33 lower than Alaska* for the office setting.

  • Nebraska

    Nebraska · 92012

    Office

    $85.37

    Facility

    $40.05

    $23.88 lower than Alaska* for the office setting.

  • New Hampshire

    New Hampshire · 92012

    Office

    $92.80

    Facility

    $41.69

    $16.45 lower than Alaska* for the office setting.

  • Northern Nj

    New Jersey · 92012

    Office

    $101.93

    Facility

    $44.97

    $7.32 lower than Alaska* for the office setting.

  • Rest Of New Jersey

    New Jersey · 92012

    Office

    $97.25

    Facility

    $43.63

    $12.00 lower than Alaska* for the office setting.

  • New Mexico

    New Mexico · 92012

    Office

    $85.84

    Facility

    $40.81

    $23.41 lower than Alaska* for the office setting.

  • Nevada**

    Nevada · 92012

    Office

    $90.41

    Facility

    $41.26

    $18.84 lower than Alaska* for the office setting.

  • Nyc Suburbs/Long Island

    New York · 92012

    Office

    $104.45

    Facility

    $46.07

    $4.80 lower than Alaska* for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 92012

    Office

    $97.69

    Facility

    $43.93

    $11.56 lower than Alaska* for the office setting.

  • Queens

    New York · 92012

    Office

    $103.62

    Facility

    $45.59

    $5.63 lower than Alaska* for the office setting.

  • Rest Of New York

    New York · 92012

    Office

    $87.28

    Facility

    $40.64

    $21.97 lower than Alaska* for the office setting.

  • Ohio

    Ohio · 92012

    Office

    $85.41

    Facility

    $40.58

    $23.84 lower than Alaska* for the office setting.

  • Oklahoma

    Oklahoma · 92012

    Office

    $84.00

    Facility

    $40.16

    $25.25 lower than Alaska* for the office setting.

  • Portland

    Oregon · 92012

    Office

    $97.28

    Facility

    $42.73

    $11.97 lower than Alaska* for the office setting.

  • Rest Of Oregon

    Oregon · 92012

    Office

    $89.98

    Facility

    $41.08

    $19.27 lower than Alaska* for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 92012

    Office

    $93.67

    Facility

    $42.56

    $15.58 lower than Alaska* for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 92012

    Office

    $85.64

    Facility

    $40.57

    $23.61 lower than Alaska* for the office setting.

  • Puerto Rico

    Puerto Rico · 92012

    Office

    $91.15

    Facility

    $41.51

    $18.10 lower than Alaska* for the office setting.

  • Rhode Island

    Rhode Island · 92012

    Office

    $92.93

    Facility

    $42.21

    $16.32 lower than Alaska* for the office setting.

  • South Carolina

    South Carolina · 92012

    Office

    $85.90

    Facility

    $40.53

    $23.35 lower than Alaska* for the office setting.

  • South Dakota**

    South Dakota · 92012

    Office

    $89.85

    Facility

    $40.75

    $19.40 lower than Alaska* for the office setting.

  • Tennessee

    Tennessee · 92012

    Office

    $84.70

    Facility

    $40.07

    $24.55 lower than Alaska* for the office setting.

  • Austin

    Texas · 92012

    Office

    $93.87

    Facility

    $41.93

    $15.38 lower than Alaska* for the office setting.

  • Beaumont

    Texas · 92012

    Office

    $85.15

    Facility

    $40.47

    $24.10 lower than Alaska* for the office setting.

  • Brazoria

    Texas · 92012

    Office

    $90.01

    Facility

    $41.36

    $19.24 lower than Alaska* for the office setting.

  • Dallas

    Texas · 92012

    Office

    $90.42

    Facility

    $41.51

    $18.83 lower than Alaska* for the office setting.

  • Fort Worth

    Texas · 92012

    Office

    $89.84

    Facility

    $41.43

    $19.41 lower than Alaska* for the office setting.

  • Galveston

    Texas · 92012

    Office

    $90.18

    Facility

    $41.42

    $19.07 lower than Alaska* for the office setting.

  • Houston

    Texas · 92012

    Office

    $90.73

    Facility

    $41.97

    $18.52 lower than Alaska* for the office setting.

  • Rest Of Texas

    Texas · 92012

    Office

    $87.42

    Facility

    $40.83

    $21.83 lower than Alaska* for the office setting.

  • Utah

    Utah · 92012

    Office

    $86.89

    Facility

    $40.73

    $22.36 lower than Alaska* for the office setting.

  • Virginia

    Virginia · 92012

    Office

    $89.22

    Facility

    $40.96

    $20.03 lower than Alaska* for the office setting.

  • Virgin Islands

    United States Virgin Islands · 92012

    Office

    $91.15

    Facility

    $41.51

    $18.10 lower than Alaska* for the office setting.

  • Vermont

    Vermont · 92012

    Office

    $89.43

    Facility

    $40.83

    $19.82 lower than Alaska* for the office setting.

  • Rest Of Washington

    Washington · 92012

    Office

    $93.79

    Facility

    $42.09

    $15.46 lower than Alaska* for the office setting.

  • Seattle (King Cnty)

    Washington · 92012

    Office

    $105.21

    Facility

    $44.97

    $4.04 lower than Alaska* for the office setting.

  • Wisconsin

    Wisconsin · 92012

    Office

    $87.35

    Facility

    $40.32

    $21.90 lower than Alaska* for the office setting.

  • West Virginia

    West Virginia · 92012

    Office

    $83.25

    Facility

    $40.58

    $26.00 lower than Alaska* for the office setting.

  • Wyoming**

    Wyoming · 92012

    Office

    $90.26

    Facility

    $41.16

    $18.99 lower than Alaska* for the office setting.

See how rates vary across the country

92012 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$81.74

$109.25

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$109.251
AL$82.731
AR$81.741
AZ$88.551
CA$96.22–$119.4129
CO$94.431
CT$95.871
DC$102.751
DE$89.861
FL$88.43–$94.463
GA$84.36–$91.752
GU$98.151
HI$98.151
IA$84.921
ID$85.291
IL$85.97–$93.094
IN$85.711
KS$84.381
KY$83.911
LA$83.71–$87.182
MA$93.92–$103.072
MD$91.45–$102.753
ME$85.43–$89.622
MI$85.53–$89.152
MN$91.521
MO$82.38–$87.703
MS$82.081
MT$90.511
NC$86.221
ND$89.921
NE$85.371
NH$92.801
NJ$97.25–$101.932
NM$85.841
NV$90.411
NY$87.28–$104.455
OH$85.411
OK$84.001
OR$89.98–$97.282
PA$85.64–$93.672
PR$91.151
RI$92.931
SC$85.901
SD$89.851
TN$84.701
TX$85.15–$93.878
UT$86.891
VA$89.22–$102.752
VI$91.151
VT$89.431
WA$93.79–$105.212
WI$87.351
WV$83.251
WY$90.261

Explore 92012 on the national rate map →

Where does this rate apply?

Alaska* is a Medicare payment area. Our Census mapping connects it to 355 cities and communities in Alaska, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Alaska →

Why are the office and facility amounts different?

For 92012 in Alaska*, the physician’s office rate is $109.25 and the facility-setting rate is $56.96: a difference of $52.29.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 92012 in Alaska*. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$120.18

$109.25 × 110% = $120.18

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92012 in Alaska*.

PPRRVU2026_Oct_nonQPP.csv

11,661

Code
92012
Physician work
0.92
Practice expense
1.76
Malpractice
0.03

GPCI2026.csv

5

Locality
Alaska*
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Office / nonfacility calculation for 92012 in Alaska*
ComponentRVULocality factorAdjusted
Physician work0.92× 1.5001.3800
Practice expense1.76× 1.0651.8744
Malpractice0.03× 0.5510.0165
Total RVUs3.2709
Conversion factor× 33.4009

Office / nonfacility rate, Alaska*$109.25

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 92012 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.921.5
Practice expense1.761.065
Malpractice0.030.551

(0.92 × 1.5 + 1.76 × 1.065 + 0.03 × 0.551) × $33.4009 = $109.25

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.921.5
Practice expense0.291.065
Malpractice0.030.551

(0.92 × 1.5 + 0.29 × 1.065 + 0.03 × 0.551) × $33.4009 = $56.96

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

92012 · Office / nonfacility

$109.25

Effective 2026-10-01

The base rate is $4.94 higher than on 2025-10-01, moving from $104.31 to $109.25 (4.7%).

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

    $104.31changed to$109.25

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.69 changed to 1.76
    • Practice expense GPCI 1.081 changed to 1.065
    • Malpractice GPCI 0.592 changed to 0.551

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $104.31

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$109.25$56.96RVU26D
2026-07-01$109.25$56.96RVU26C
2026-04-01$109.25$56.96RVU26B
2026-01-01$109.25$56.96RVU26A
2025-10-01$104.31$63.74RVU25D
2025-07-01$104.31$63.74RVU25C
2025-04-01$104.31$63.74RVU25B
2025-01-01$104.31$63.74RVU25A

92012 billing questions

When should 92014 be reported instead of 92012?

Use 92014 when the documented service is a comprehensive evaluation of the visual system. Use 92012 when the documented examination is intermediate in scope, with diagnostic steps directed by the patient's concern.

Can 92012 be billed with an office E/M code on the same date?

Do not report 92012 and an office E/M code such as 99213 for the same examination and management work. A distinct, separately documented E/M service may be reportable on the same date when its coding requirements are met.

Is refraction included in 92012?

No. Determining refractive error for a lens prescription is reported separately with 92015 when performed.

Should modifier 50 or RT and LT be appended when both eyes are examined?

Do not use modifier 50 to seek additional payment; CMS already prices 92012 as bilateral. RT and LT may identify the examined side when needed, but examining both eyes does not create two units.

Does dilation have to be performed to report 92012?

No. Dilation may be part of an intermediate examination when clinically indicated, but it is not required for this level.

Who counts as an established patient for this code?

A patient who received professional services from the same provider, or another provider of the same specialty in the same group, within the prior three years.

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.

RVUs for 92012PPRRVU2026_Oct_nonQPP.csv, line 11,661 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet