How much does Medicare pay for CPT 92014?

Medicare allowed an average of $124.11 per service and paid $83.01 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $227.33, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92014?

Established patient complete exam of visual system. It was billed 9,164,899 times to 7,934,569 Medicare beneficiaries by 35,261 providers in 2024.

Does 92014 pay differently in an office than a hospital?

Yes. The allowed amount averaged $124.81 in an office setting and $75.05 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 92014 most?

Ophthalmology, with 5,625,470 services from 11,940 clinicians. Next are Optometry, Physician Assistant, Nurse Practitioner.

CPT 92014

Established patient complete exam of visual system

$124.11Medicare-allowed amount per service, averaged across 9,164,899 services

Providers submitted

$227.33

Asking price, not received

Medicare allowed

$124.11

The fee schedule figure

Medicare paid

$83.01

Balance is patient coinsurance

Providers submitted an average of $227.33 for this code and Medicare allowed $124.11 — 1.8× 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 $83.01 (67%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $124.81
Hospital / facility: $75.05

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 9,035,586 services were billed in an office setting and 129,313 in a facility.

Services: 9,164,899
Beneficiaries: 7,934,569
Providers billing it: 35,261
Total allowed: $1,137,455,615

What Medicare pays for CPT 92014

Across 9,164,899 services billed by 35,261 providers to 7,934,569 beneficiaries, Medicare allowed an average of $124.11 per service. That is 1.2 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 92014

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	5,625,470	4,544,470	$126.63	11,940
Optometry	3,528,029	3,380,024	$120.14	23,259
Physician Assistant	4,876	4,556	$99.27	27
Nurse Practitioner	2,207	2,140	$101.26	11
General Practice	931	817	$144.80	2
Gastroenterology	693	549	$125.98	1
Internal Medicine	610	544	$101.70	6
Pathology	573	341	$71.21	1
Family Practice	525	312	$119.47	3
Pediatric Medicine	345	224	$122.44	2
Neurology	307	264	$99.64	4
Unknown Supplier/Provider Specialty	244	240	$121.50	2
Clinic or Group Practice	51	51	$134.15	1
Osteopathic Manipulative Medicine	20	19	$112.96	1
Physical Medicine and Rehabilitation	18	18	$124.59	1

92014 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.

State	Services	Allowed	Standardized pmt	Providers
California	863,754	$138.44	$84.57	2,866
Florida	707,159	$122.10	$84.19	2,144
Texas	677,404	$121.38	$82.88	2,762
New York	669,818	$135.32	$85.11	2,190
Illinois	406,587	$122.32	$81.59	1,416
New Jersey	402,900	$137.46	$86.15	1,138
Pennsylvania	387,137	$120.89	$81.01	1,557
Massachusetts	365,393	$129.44	$79.37	1,092
Virginia	337,598	$125.15	$81.20	886
Maryland	278,334	$132.08	$83.23	637
Ohio	234,898	$112.82	$77.92	1,363
Georgia	210,586	$119.15	$82.50	842
Tennessee	204,092	$115.55	$82.45	800
Michigan	195,582	$117.92	$80.88	1,046
North Carolina	185,006	$117.92	$81.56	853
Arizona	179,710	$121.54	$81.82	652
South Carolina	166,937	$117.52	$81.34	544
Missouri	165,213	$117.33	$81.56	705
Washington	154,773	$128.22	$78.66	783
Louisiana	144,648	$112.79	$81.65	465
Kansas	133,770	$115.37	$78.45	526
Iowa	131,338	$115.21	$78.73	505
Minnesota	129,303	$120.45	$75.69	831
Wisconsin	128,581	$111.73	$73.63	722
Indiana	123,529	$115.78	$80.30	729
Colorado	123,390	$123.06	$77.56	676
Oklahoma	120,903	$112.87	$80.82	534
Connecticut	116,551	$131.96	$83.01	579
Mississippi	106,767	$110.63	$82.15	345
Arkansas	95,006	$110.98	$81.40	376
Oregon	91,478	$124.62	$78.56	439
Kentucky	75,119	$114.40	$82.53	411
Nebraska	72,181	$114.11	$78.40	284
Alabama	71,024	$112.23	$83.29	422
Utah	69,156	$113.75	$76.16	314
New Hampshire	58,804	$122.86	$76.62	203
Hawaii	56,233	$131.73	$78.10	226
Nevada	53,884	$122.69	$80.93	297
Montana	49,365	$122.69	$75.55	177
Idaho	49,298	$116.04	$78.98	227
New Mexico	47,124	$114.64	$78.44	184
Maine	46,173	$118.94	$76.46	236
South Dakota	43,400	$120.39	$77.86	191
West Virginia	39,557	$113.43	$79.79	171
Delaware	37,272	$123.94	$81.14	110
North Dakota	36,494	$116.02	$73.89	172
Rhode Island	35,048	$124.84	$81.25	187
Vermont	26,415	$122.04	$75.45	102
Wyoming	23,645	$123.09	$76.44	87
District of Columbia	13,547	$134.39	$83.31	48
Alaska	12,574	$143.20	$73.71	99
Puerto Rico	5,391	$122.67	$82.88	85
Guam	2,662	$131.34	$74.56	9
U.S. Virgin Islands	1,238	$122.95	$70.17	9
Northern Mariana Islands	561	$134.11	$60.44	3
AA	323	$116.18	$77.55	1

Related codes

92012Established patient problem focused exam of visual system$90.55
92083Exam of visual field$61.28
92004New patient complete exam of visual system$145.45
92020Exam of the internal drainage system of eye$27.92
92025Ct scan of cornea$34.33
92060Exam to measure eye deviation and range of motion$60.27
92082Exam of visual field$43.78
92002New patient problem focused exam of visual system$84.57
92081Exam of visual field$30.43
92065Eye training exercise performed by health care professional$39.76
92071Fitting of contact lens for treatment of eye surface disease$37.72
92066Eye training exercise under supervision of health care professional$26.12

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.