Billing code 92002: Eye examinationMedicare rate & RVUs in Maryland
An ophthalmologist or optometrist reports this intermediate examination for a new patient when evaluating an eye concern and beginning a diagnostic or treatment plan.
Medicare pays $85.73–$96.25 for 92002 in the office in Maryland, from Rest Of Maryland to Dc + Md/Va Suburbs. 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 92002 covers
This service is an intermediate ophthalmological evaluation for a new patient, commonly performed by an ophthalmologist or optometrist in an office or outpatient setting. The clinician evaluates the patient’s eye complaint or finding, examines relevant ocular structures, and uses diagnostic procedures as indicated to decide on an initial diagnostic or treatment approach. Examples of reasons for evaluation include new blurred vision, eye discomfort, or a newly observed ocular finding.
Select 92002 when the documented service is intermediate rather than a comprehensive eye examination and the patient meets the new-patient criteria for the reporting clinician and group. The record should support the eye-related history, examination performed, relevant findings, and the diagnostic or treatment plan initiated. The code is priced as bilateral; reporting modifier 50 does not increase payment. Report a separate diagnostic service only when it was performed and is independently reportable.
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 92002 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$85.73 to $96.25
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore/Surr. Cntys | $89.47 | $38.93 |
| Dc + Md/Va Suburbs | $96.25 | $40.77 |
| Rest Of Maryland | $85.73 | $38.07 |
How the 92002 rate is calculated
Each of 92002’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 · 92002
RVUs × geographic indexes × conversion factor
Work0.88
0.88 RVUs× 1.000 GPCI
Practice expense1.64
1.64 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
2.5400
Conversion factor
$33.4009
Medicare rate
$84.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92002
The CMS indicators that decide how 92002 is paid alongside other services.
CMS payment indicators · 92002
Eye examination
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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 | 0 | Physician service: no professional/technical split. |
92002 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92004Comprehensive eye exam
- Both are for new patients, but 92004 represents a comprehensive eye examination; 92002 represents an intermediate examination.
- 92012Eye exam
- Both describe an intermediate ophthalmological examination. Use 92002 for a new patient and 92012 for an established patient.
- 92014Comprehensive eye exam
- 92014 is the comprehensive examination for an established patient. 92002 is intermediate and applies to a new patient.
92002 billing questions
When should 92002 be chosen over 92004?
Use 92002 for an intermediate new-patient ophthalmological evaluation. Choose 92004 when the service meets the level of a comprehensive new-patient eye examination.
Can 92002 be reported for an established patient?
No. The intermediate eye-examination code for an established patient is 92012. Apply the new-patient criteria to the reporting clinician and group.
Should modifier 50 be appended when both eyes are examined?
No. CMS prices 92002 as bilateral, and modifier 50 does not increase its payment.
Is a refraction included in 92002?
A refraction is a distinct service reported with 92015 when performed and separately reportable. Document the refraction separately from the evaluation supporting 92002.
What documentation supports 92002?
Document the eye-related history, examination and findings, diagnostic procedures performed as indicated, and the diagnostic or treatment plan initiated. The record should support an intermediate—not comprehensive—level of examination.
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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