RxDoctor Payments Data

CPT 83861

Microfluid analysis of tears

$21.96Medicare-allowed amount per service, averaged across 491,299 services
Providers submitted
$46.27

Asking price, not received

Medicare allowed
$21.96

The fee schedule figure

Medicare paid
$21.96

Balance is patient coinsurance

Providers submitted an average of $46.27 for this code and Medicare allowed $21.962.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $21.96 (100%); the rest is the patient’s coinsurance and deductible.

Services
491,299

Medicare Part B, 2024

Beneficiaries
181,133
Providers billing it
1,715
Total allowed
$10,788,926

Services × allowed amount

What Medicare pays for CPT 83861

Across 491,299 services billed by 1,715 providers to 181,133 beneficiaries, Medicare allowed an average of $21.96 per service. That is 2.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 83861

SpecialtyServicesBeneficiariesAvg allowedProviders
Ophthalmology285,820110,267$21.97806
Optometry204,64770,492$21.96900
Physician Assistant471221$21.896
Pathology16872$21.581
Family Practice15163$22.031
Nurse Practitioner4218$22.031

83861 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
California74,101$21.95$22.03100
New York62,248$21.99$22.03171
Virginia31,633$21.93$22.0399
Florida30,018$21.98$22.0391
Illinois29,825$21.97$22.03109
Texas27,824$21.89$22.0381
Pennsylvania22,032$21.99$22.0380
New Jersey21,572$22.00$22.0357
Maryland21,451$21.97$22.0351
North Carolina16,032$21.97$22.0349
Indiana12,288$21.93$22.0373
Ohio12,014$21.92$22.0370
Michigan11,404$21.98$22.0365
Missouri9,991$21.93$22.0334
Georgia9,919$21.98$22.0350
Tennessee7,303$21.98$22.0330
South Carolina7,256$21.92$22.0343
Massachusetts5,973$22.00$22.0320
Mississippi5,962$21.99$22.0329
Kansas5,762$22.01$22.0316
Connecticut5,358$21.98$22.0225
South Dakota5,229$21.98$22.0326
Oklahoma4,953$21.98$22.0323
Kentucky4,900$21.93$22.0327
Arizona4,719$22.01$22.0314
Minnesota4,606$22.02$22.0335
West Virginia2,922$22.01$22.0312
Washington2,844$21.96$22.0330
Iowa2,786$22.02$22.0311
Alaska2,776$21.99$22.0311
Oregon2,765$22.00$22.0314
Hawaii2,700$21.74$22.0322
New Mexico2,484$21.96$22.039
New Hampshire2,248$21.92$22.0324
Nebraska2,172$21.97$22.0314
Louisiana2,148$21.89$22.0318
Wyoming2,103$21.99$22.032
Alabama1,596$22.01$22.039
Puerto Rico1,538$22.03$22.0319
Arkansas1,251$21.95$22.037
Colorado841$22.03$22.0313
Maine750$21.96$22.037
Nevada692$21.92$22.035
North Dakota582$22.03$22.034
Rhode Island535$21.99$22.031
Wisconsin436$21.86$22.035
Delaware234$21.86$22.032
District of Columbia169$22.03$22.031
Montana166$22.03$22.034
Guam111$21.72$22.031
Idaho77$22.03$22.032

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.