How much does Medicare pay for CPT 92065?

Medicare allowed an average of $39.76 per service and paid $30.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $91.88, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92065?

Eye training exercise performed by health care professional. It was billed 14,378 times to 2,053 Medicare beneficiaries by 66 providers in 2024.

Which specialty bills 92065 most?

Optometry, with 14,068 services from 63 clinicians. Next are Family Practice, Ophthalmology.

CPT 92065

Eye training exercise performed by health care professional

$39.76Medicare-allowed amount per service, averaged across 14,378 services

Providers submitted

$91.88

Asking price, not received

Medicare allowed

$39.76

The fee schedule figure

Medicare paid

$30.70

Balance is patient coinsurance

Providers submitted an average of $91.88 for this code and Medicare allowed $39.76 — 2.3× 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 $30.70 (77%); the rest is the patient’s coinsurance and deductible.

Services: 14,378
Beneficiaries: 2,053
Providers billing it: 66
Total allowed: $571,669

What Medicare pays for CPT 92065

Across 14,378 services billed by 66 providers to 2,053 beneficiaries, Medicare allowed an average of $39.76 per service. That is 7.0 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 92065

Specialty	Services	Beneficiaries	Avg allowed	Providers
Optometry	14,068	1,977	$39.77	63
Family Practice	231	16	$39.01	1
Ophthalmology	79	60	$40.79	2

92065 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
New York	3,014	$42.00	$30.86	14
California	2,881	$42.33	$30.40	9
Arizona	2,757	$36.05	$30.13	4
Pennsylvania	965	$38.43	$30.66	5
Massachusetts	785	$40.16	$29.98	3
New Jersey	629	$42.88	$30.27	2
Wyoming	572	$36.20	$28.88	1
Delaware	559	$38.99	$29.27	2
Texas	329	$40.10	$28.70	4
Michigan	328	$38.44	$30.89	6
South Carolina	238	$37.47	$28.97	1
Florida	232	$39.07	$29.65	2
Connecticut	202	$40.47	$28.91	2
Wisconsin	177	$37.99	$30.97	1
North Carolina	164	$35.28	$28.46	2
Illinois	149	$39.84	$30.39	2
Kansas	136	$38.66	$24.34	2
Kentucky	123	$36.82	$29.38	1
Maryland	79	$40.45	$30.63	1
Washington	34	$39.60	$30.07	1
Ohio	25	$37.47	$30.93	1

Related codes

92014Established patient complete exam of visual system$124.11
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
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.