Billing code 92018: Eye examinationMedicare rate & RVUs in Texas
A comprehensive ophthalmic assessment performed under general anesthesia when a complete, reliable examination cannot be obtained while the patient is awake.
CMS doesn’t publish an office rate for 92018 in Texas.
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 92018 covers
An ophthalmologist performs a full diagnostic eye assessment while the patient is under general anesthesia, allowing evaluation when a reliable examination cannot be completed awake. Common situations include a young child or a patient with significant developmental, behavioral, or physical limitations. The examination may take place in an operating room or another anesthesia-capable setting, and may include manipulation of the globe when needed for diagnostic or therapeutic purposes. This service is broader than a limited anesthetized eye examination.
Select 92018 when the documented ophthalmic work is comprehensive rather than a targeted check of one problem. Record why anesthesia was needed, which examination elements were completed, the findings, and any manipulation or treatment performed. The anesthesia setting alone does not establish the comprehensive level; the scope of the eye examination does. Document the service as a comprehensive assessment rather than splitting its routine examination observations among separate eye-exam codes. A limited examination under anesthesia is reported with 92019.
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 92018 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $114.60 |
| Beaumont | Unavailable | $110.44 |
| Brazoria | Unavailable | $112.82 |
| Dallas | Unavailable | $113.33 |
| Fort Worth | Unavailable | $113.10 |
| Galveston | Unavailable | $113.05 |
| Houston | Unavailable | $115.07 |
| Rest Of Texas | Unavailable | $111.44 |
How the 92018 rate is calculated
Each of 92018’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 · 92018
RVUs × geographic indexes × conversion factor
Work2.44
2.44 RVUs× 1.000 GPCI
Practice expense0.84
0.84 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
3.3900
Conversion factor
$33.4009
Medicare rate
$113.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92018
92018 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 92018
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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92018 isn’t priced in this setting.
92018 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92019Eye examination
- Both describe an ophthalmic examination under general anesthesia. Choose 92018 for comprehensive work and 92019 for a limited examination.
- 92004Comprehensive eye exam
- 92004 is a comprehensive eye examination for a new patient who can be examined without general anesthesia; 92018 is selected for a comprehensive assessment performed under anesthesia.
- 92014Comprehensive eye exam
- 92014 is the comprehensive eye examination for an established patient examined without general anesthesia. 92018 is distinguished by the comprehensive examination under anesthesia.
92018 billing questions
When should 92018 be chosen over 92019?
Use 92018 for a comprehensive ophthalmic assessment under anesthesia. Use 92019 when the anesthetized examination is limited in scope.
Does the patient have to be a child?
No. The relevant circumstance is the need for general anesthesia to obtain the documented examination, not the patient's age.
Does 92018 include the anesthesia service?
No. 92018 represents the ophthalmologist's examination; the anesthesia professional's service is separate.
Does general anesthesia itself require a modifier?
General anesthesia alone is not a reason to append a modifier to 92018.
What documentation supports reporting 92018?
Document why an examination while awake was not feasible, the scope of the comprehensive eye assessment, the findings, and any globe manipulation or treatment performed.
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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