$30.47
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.
On this page
CMS RVU26D · Effective 2026-10-01
92134 Retinal OCT Medicare reimbursement rates in Delaware
Computerized scanning imaging of the retina, typically macular optical coherence tomography, is reported for an interpreted study of one or both eyes. Compare 92134 office and facility rates across CMS payment localities in Delaware.
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 92134 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$32.46
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
Ophthalmic diagnostic imaging
About 92134: Retinal OCT with interpretation and report
Computerized scanning imaging of the retina, typically macular optical coherence tomography, is reported for an interpreted study of one or both eyes.
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.
CMS billing rules for 92134
- 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 RVU0.31 · 32%
- Practice expense (office) RVU0.65 · 66%
- Malpractice RVU0.02 · 2%
8.2M
Medicare services in 2024 · #27 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.
92134 compared with similar codes
Office rates for Delaware, from the same CMS release.
$59.36
92137 addresses retinal imaging with OCT angiography; report 92134 when the retinal study consists of structural scanning imaging without OCT angiography.
$36.79
92250 produces fundus photographs of the retina, while 92134 produces cross-sectional scanning images used to assess retinal layers and thickness.
Compare 92134 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
$32.46
Facility
Unavailable
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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 92134 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
11,693
- Code
- 92134
- Physician work
- 0.31
- Practice expense
- 0.65
- Malpractice
- 0.02
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.31 | × 1.005 | 0.3115 |
| Practice expense | 0.65 | × 0.988 | 0.6422 |
| Malpractice | 0.02 | × 0.899 | 0.0180 |
| Total RVUs | 0.9717 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$32.46
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.31 | 1.005 |
| Practice expense | 0.65 | 0.988 |
| Malpractice | 0.02 | 0.899 |
(0.31 × 1.005 + 0.65 × 0.988 + 0.02 × 0.899) × $33.4009 = $32.46
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.
92134 billing questions
Should one unit or two be reported when both eyes are scanned?
Report one unit for the session. The code covers one or both eyes and is priced as bilateral, so modifier 50 or a second unit for the other eye does not increase payment.
Can retinal OCT and optic nerve OCT be billed on the same day?
92134 addresses retinal imaging, while 92133 addresses optic nerve imaging. Do not report both for a single scan; each requires a distinct, documented study of its respective target.
When is modifier 26 or TC used?
Use modifier 26 when billing only the interpretation and modifier TC when billing only the equipment and staff portion. Bill the global code without either modifier when the billing entity furnishes both components.
Can 92134 be reported with OCT angiography of the retina?
Code 92137 describes retinal OCT angiography. Report 92137 instead of 92134 when the documented retinal study includes OCT angiography.
Is it billable on the same day as an intravitreal injection?
Yes. Macular OCT may be performed before an anti-VEGF injection (67028) to assess fluid and guide treatment; report the interpreted test separately when medically necessary.
What documentation supports the interpretation?
A signed report should identify the eyes imaged and findings such as retinal fluid or thickness, with comparison to prior studies when available. Image printouts without a written interpretation do not support the professional component.
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.
11,69092133,,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
11,69492134,26,Cptrz oph dx img pst sgm rta,A,,0.31,0.21,,0.21,,0.01,0.53,0.53,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,69592134,TC,Cptrz oph dx img pst sgm rta,A,,0.00,0.44,,0.44,NA,0.01,0.45,0.45,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,1.76,1.76,0.04
11,69692136,,Ophthalmic biometry,A,,0.53,0.89,,0.89,NA,0.02,1.44,1.44,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503