Billing code 92136: Optical biometryMedicare rate & RVUs in Maine
Optical biometry measures eye dimensions and calculates intraocular lens power, typically before cataract surgery or refractive lens exchange.
Medicare pays $45.47–$47.58 for 92136 in the office in Maine, from Rest Of Maine to Southern Maine. Which amount applies depends on the service address.
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 9 sections
What 92136 covers
Optical biometry uses partial coherence interferometry or similar optical technology to measure axial length without touching the eye. Devices may also capture keratometry, anterior chamber depth, and other dimensions used in intraocular lens calculations. An ophthalmic technician or assistant typically acquires the measurements in an eye clinic or outpatient department. The ophthalmologist interprets the results and calculates lens power for a patient preparing for cataract surgery or refractive lens exchange.
Report 92136 when optical biometry includes an intraocular lens power calculation. Retain the measurements, the calculated lens power, and the interpreting clinician’s report; record the formula and other inputs used when available. Modifier TC identifies the equipment-and-staff portion, and modifier 26 identifies the interpretation and calculation portion. Billing without either modifier represents the global service. CMS prices the code as bilateral, so modifier 50 does not increase payment; measuring the second eye alone does not support another technical unit. The ophthalmology diagnostic multiple procedure reduction applies to the technical component when this test is billed with other eligible diagnostic tests.
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 92136 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | $45.47 | Unavailable |
| Southern Maine | $47.58 | Unavailable |
How the 92136 rate is calculated
Each of 92136’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 · 92136
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.53Practice expense 0.89Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92136
The CMS indicators that decide how 92136 is paid alongside other services.
CMS payment indicators · 92136
Optical biometry
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 7 | Diagnostic ophthalmology reduction applies to the technical component. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
92136 without 26 · national office
$48.10
Optical biometry
92136-26 · Professional component
$30.06
Pays only the interpretation and report.
92136 compared with similar codes
Compare codes
92136 vs 76519 vs 76516 vs 92132: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76519Ocular biometry
- Both include an IOL power calculation. 92136 uses optical biometry, while 76519 uses ultrasound A-scan biometry.
- 76516Eye biometry
- 76516 is ultrasound A-scan biometry without an IOL power calculation. 92136 is optical biometry that includes the calculation.
- 92132Eye imaging
- 92132 images anterior eye structures, such as the angle or cornea. It is not optical biometry with an IOL power calculation.
92136 billing questions
When is 76519 reported instead of 92136?
Report 76519 when ultrasound A-scan biometry provides the measurements and an intraocular lens power calculation. An optical reading may be unobtainable with a dense cataract or poor fixation.
Can modifier 50 be appended when both eyes are measured?
Modifier 50 does not increase payment because CMS already prices 92136 as bilateral. Measurements of both eyes in one session do not justify a second technical unit.
How do modifiers 26 and TC split the service?
Modifier TC identifies the equipment-and-staff portion; modifier 26 identifies the professional interpretation and lens power calculation. Bill the applicable component when reporting only that portion, or report the global service when billing both together.
Does a multiple procedure reduction apply when OCT is done the same day?
The ophthalmology diagnostic multiple procedure reduction applies to the technical component of eligible tests performed on the same date, which may include 92136 with retinal OCT. It does not reduce the professional component under this rule.
What documentation supports billing 92136?
Keep the optical biometry measurements, the intraocular lens power calculation, and the interpreting clinician’s report. Document the calculation inputs, such as keratometry and the formula used, when available.
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
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