$65.25–$72.02
Both include an IOL power calculation. 92136 uses optical biometry, while 76519 uses ultrasound A-scan biometry.
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CMS RVU26D · Effective 2026-10-01
92136 Optical biometry Medicare reimbursement rates in Pennsylvania
Optical biometry measures eye dimensions and calculates intraocular lens power, typically before cataract surgery or refractive lens exchange. Compare 92136 office and facility rates across CMS payment localities in Pennsylvania.
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 92136 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$45.62–$49.76
2 of 2 localities have a supported rate.
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 testing
About 92136: Optical biometry with intraocular lens power calculation
Optical biometry measures eye dimensions and calculates intraocular lens power, typically before cataract surgery or refractive lens exchange.
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.
CMS billing rules for 92136
- 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 RVU0.53 · 37%
- Practice expense (office) RVU0.89 · 62%
- Malpractice RVU0.02 · 1%
1.7M
Medicare services in 2024 · #92 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.
92136 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$44.93–$49.52
76516 is ultrasound A-scan biometry without an IOL power calculation. 92136 is optical biometry that includes the calculation.
$28.07–$30.83
92132 images anterior eye structures, such as the angle or cornea. It is not optical biometry with an IOL power calculation.
Compare 92136 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$49.76
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$45.62
Facility
Unavailable
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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 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.
11,69392134,,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
11,69492134,26,Cptrz oph dx img pst sgm rta,A,,0.31,0.21,,0.21,,0.01,0.53,0.53,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,69592134,TC,Cptrz oph dx img pst sgm rta,A,,0.00,0.44,,0.44,NA,0.01,0.45,0.45,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,1.76,1.76,0.04
11,69692136,,Ophthalmic biometry,A,,0.53,0.89,,0.89,NA,0.02,1.44,1.44,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,69792136,26,Ophthalmic biometry,A,,0.53,0.36,,0.36,,0.01,0.90,0.90,1,XXX,0.00,0.00,0.00,7,3,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,69892136,TC,Ophthalmic biometry,A,,0.00,0.53,,0.53,NA,0.01,0.54,0.54,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,69992137,,Cptrz oph img pst sg rta oct,A,,0.62,1.15,,1.15,NA,0.02,1.79,1.79,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,6.93,6.93,0.10