No office rate
Both describe ophthalmic examinations under general anesthesia. Choose 92019 for a limited examination and 92018 when the documented examination is comprehensive.
On this page
CMS RVU26D · Effective 2026-10-01
92019 Eye examination Medicare reimbursement rates in Indiana
A limited ophthalmic examination performed under general anesthesia when a patient cannot complete the needed diagnostic examination while awake. Compare 92019 office and facility rates across CMS payment localities in Indiana.
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 92019 in Indiana?
Indiana 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
No supported rate
Facility setting
$56.73
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
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.
Ophthalmology
About 92019: Limited eye examination under anesthesia
A limited ophthalmic examination performed under general anesthesia when a patient cannot complete the needed diagnostic examination while awake.
92019 represents a limited ophthalmic diagnostic examination performed while the patient is under general anesthesia. It is commonly used for young children or patients who cannot cooperate sufficiently for an adequate examination while awake. An ophthalmologist examines the eyes and performs the maneuvers needed to address the clinical question, typically in an anesthesia-supported setting. The code represents the eye examination, not the administration of anesthesia.
Select 92019 when the examination under anesthesia is limited in scope; use 92018 when the documented examination is comprehensive. The distinction is based on the scope of the examination, not its duration or whether one or both eyes are examined. Documentation should explain why general anesthesia was needed and identify the examination performed and findings that support the limited level.
Where the value comes from
- Work RVU1.28 · 73%
- Practice expense (office) RVU0.42 · 24%
- Malpractice RVU0.06 · 3%
229
Medicare services in 2024 · #4207 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.
92019 compared with similar codes
Office rates for Indiana, from the same CMS release.
$80.50
92002 is an intermediate ophthalmological examination for a new patient performed outside the general-anesthesia examination context. Use 92019 for a limited examination performed under general anesthesia.
$85.71
92012 is an intermediate ophthalmological examination for an established patient performed outside the general-anesthesia examination context. Use 92019 for a limited examination performed under general anesthesia.
Compare 92019 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
Indiana →
Office / nonfacility
Unavailable
Facility
$56.73
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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 92019 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
11,665
- Code
- 92019
- Physician work
- 1.28
- Practice expense
- 0.42
- Malpractice
- 0.06
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.28 | × 1.000 | 1.2800 |
| Practice expense | 0.42 | × 0.927 | 0.3893 |
| Malpractice | 0.06 | × 0.486 | 0.0292 |
| Total RVUs | 1.6985 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$56.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.28 | 1 |
| Practice expense | 0.42 | 0.927 |
| Malpractice | 0.06 | 0.486 |
(1.28 × 1 + 0.42 × 0.927 + 0.06 × 0.486) × $33.4009 = $56.73
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.
92019 billing questions
How does 92019 differ from 92018?
92019 is for a limited examination under general anesthesia; 92018 is for a comprehensive examination under general anesthesia. The documented scope of the examination determines which code fits.
Can 92019 be reported for an awake office examination?
No. This code describes an examination performed under general anesthesia; an awake examination is coded from the applicable ophthalmological examination family based on its scope and patient status.
Does 92019 include the anesthesia service?
It represents the ophthalmologist’s examination while the patient is under general anesthesia, not the administration of anesthesia.
Does limited mean a short examination or examination of one eye?
No. The code level reflects the scope of the examination, not its duration or laterality.
What documentation supports reporting 92019?
Document why the patient needed general anesthesia, the examination performed, the findings, and why the examination was limited rather than comprehensive.
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.
11,66292014,,Compre oph exam est pt 1/>,A,,1.42,2.35,,0.40,,0.04,3.81,1.86,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,66392015,,Determine refractive state,N,+,0.37,0.18,,0.08,,0.02,0.57,0.47,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,66492018,,Compl oph exam general anes,A,,2.44,0.84,NA,0.84,,0.11,3.39,3.39,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,66592019,,Lmtd oph exam general anes,A,,1.28,0.42,NA,0.42,,0.06,1.76,1.76,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,66692020,,Gonioscopy,A,,0.36,0.43,,0.12,,0.01,0.80,0.49,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,66792025,,Cptrized corneal topography,A,,0.34,0.75,,0.75,NA,0.02,1.11,1.11,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,66892025,26,Cptrized corneal topography,A,,0.34,0.23,,0.23,,0.01,0.58,0.58,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915