Billing code 92133: Optic nerve OCTMedicare rate & RVUs in Ohio
Scanning laser or OCT imaging of the optic nerve head and retinal nerve fiber layer, reported mainly for glaucoma diagnosis and monitoring.
Medicare pays $28.99 for 92133 in the office in Ohio (Ohio). 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 92133 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $28.99 | Unavailable |
How the 92133 rate is calculated
Each of 92133’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 · 92133
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.30Practice expense 0.60Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92133
The CMS indicators that decide how 92133 is paid alongside other services.
CMS payment indicators · 92133
Optic nerve OCT
| 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
92133 without 26 · national office
$30.73
Optic nerve OCT
92133-26 · Professional component
$16.37
Pays only the interpretation and report.
92133 compared with similar codes
Compare codes
92133 vs 92134 vs 92137 vs 92132 vs 92250: national Medicare rates
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How to choose
- 92134Retinal OCT
- 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.
- 92137OCT angiography
- 92137 is retinal imaging that includes OCT angiography of retinal vasculature; 92133 assesses optic nerve structure without angiography.
- 92132Eye imaging
- 92132 images the anterior segment, such as the angle or cornea; 92133 images the optic nerve in the posterior segment.
- 92250Fundus photography
- 92250 is fundus photography producing images of the retina and disc; 92133 provides quantitative scanning measurements of nerve fiber layer thickness.
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?
billing code 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 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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