$30.48
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 in Iowa
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 in Iowa.
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 in Iowa?
Iowa 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
$28.62
1 of 1 localities have a supported rate.
Payment area: Iowa
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 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 rates for Iowa, from the same CMS release.
$56.12
92137 is retinal imaging that includes OCT angiography of retinal vasculature; 92133 assesses optic nerve structure without angiography.
$27.65
92132 images the anterior segment, such as the angle or cornea; 92133 images the optic nerve in the posterior segment.
$34.68
92250 is fundus photography producing images of the retina and disc; 92133 provides quantitative scanning measurements of nerve fiber layer thickness.
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.
1 of 1 payment localities
Iowa →
Office / nonfacility
$28.62
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 92133 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
11,690
- Code
- 92133
- Physician work
- 0.30
- Practice expense
- 0.60
- Malpractice
- 0.02
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.30 | × 1.000 | 0.3000 |
| Practice expense | 0.60 | × 0.915 | 0.5490 |
| Malpractice | 0.02 | × 0.397 | 0.0079 |
| Total RVUs | 0.8569 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$28.62
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.3 | 1 |
| Practice expense | 0.6 | 0.915 |
| Malpractice | 0.02 | 0.397 |
(0.3 × 1 + 0.6 × 0.915 + 0.02 × 0.397) × $33.4009 = $28.62
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.
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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136