How much does Medicare pay for CPT 92081?

Medicare allowed an average of $30.43 per service and paid $21.64 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $87.55, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92081?

Exam of visual field with limited testing. It was billed 72,013 times to 68,962 Medicare beneficiaries by 981 providers in 2024.

Does 92081 pay differently in an office than a hospital?

Yes. The allowed amount averaged $30.78 in an office setting and $16.12 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 92081 most?

Ophthalmology, with 48,110 services from 619 clinicians. Next are Optometry, Plastic and Reconstructive Surgery, Internal Medicine.

CPT 92081

Exam of visual field with limited testing

$30.43Medicare-allowed amount per service, averaged across 72,013 services

Providers submitted

$87.55

Asking price, not received

Medicare allowed

$30.43

The fee schedule figure

Medicare paid

$21.64

Balance is patient coinsurance

Providers submitted an average of $87.55 for this code and Medicare allowed $30.43 — 2.9× 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 $21.64 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $30.78
Hospital / facility: $16.12

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. 70,305 services were billed in an office setting and 1,708 in a facility.

Services: 72,013
Beneficiaries: 68,962
Providers billing it: 981
Total allowed: $2,191,356

What Medicare pays for CPT 92081

Across 72,013 services billed by 981 providers to 68,962 beneficiaries, Medicare allowed an average of $30.43 per service. 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 92081

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	48,110	46,100	$29.82	619
Optometry	22,165	21,204	$31.62	343
Plastic and Reconstructive Surgery	1,098	1,076	$31.06	8
Internal Medicine	207	207	$38.10	2
Physician Assistant	148	145	$26.73	3
Rheumatology	112	101	$35.29	1
Neurology	68	24	$35.81	1
General Practice	45	45	$37.71	1
Otolaryngology	37	37	$28.15	1
Family Practice	23	23	$32.78	2

92081 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	6,142	$34.88	$22.40	98
Texas	5,450	$30.17	$21.96	95
Florida	4,700	$30.31	$21.85	57
New York	4,476	$33.38	$22.53	52
Oklahoma	3,489	$27.69	$21.87	25
Arizona	2,858	$27.63	$22.15	33
Washington	2,213	$32.26	$22.09	27
Ohio	2,116	$30.75	$23.27	18
Virginia	2,056	$31.68	$21.77	21
North Carolina	2,050	$28.65	$21.20	28
Pennsylvania	1,954	$31.78	$22.35	30
Kansas	1,902	$30.51	$22.29	16
Massachusetts	1,872	$29.46	$19.57	23
Nevada	1,764	$31.85	$21.61	19
New Jersey	1,714	$35.16	$23.13	27
Maryland	1,700	$35.90	$22.82	13
Illinois	1,684	$31.82	$22.24	22
Tennessee	1,633	$28.57	$22.63	19
Minnesota	1,609	$30.34	$21.55	29
Michigan	1,577	$28.99	$21.54	31
Missouri	1,537	$29.19	$22.20	20
Colorado	1,524	$24.23	$19.86	26
Connecticut	1,327	$34.13	$23.22	19
South Carolina	1,303	$29.36	$22.20	17
Iowa	1,269	$29.74	$22.20	20
Georgia	1,176	$27.43	$21.09	18
Louisiana	1,030	$25.36	$19.65	16
Wisconsin	962	$25.50	$18.11	17
Kentucky	879	$28.94	$22.84	13
South Dakota	874	$30.27	$21.81	8
Oregon	862	$28.45	$19.01	16
Arkansas	832	$25.23	$20.53	6
Nebraska	793	$29.15	$22.63	8
Indiana	748	$30.45	$22.06	11
Alabama	617	$27.31	$21.74	12
Mississippi	550	$26.93	$21.59	11
Utah	514	$27.44	$21.68	9
New Hampshire	336	$26.99	$19.83	4
Montana	297	$29.95	$20.42	7
North Dakota	273	$28.22	$19.59	4
Delaware	271	$24.02	$15.52	7
West Virginia	243	$18.45	$17.34	6
New Mexico	213	$28.42	$20.80	4
Idaho	180	$28.02	$22.64	4
Hawaii	169	$35.03	$22.49	4
Maine	72	$29.33	$19.88	2
Rhode Island	66	$33.56	$25.52	2
Alaska	39	$30.57	$23.02	2
Vermont	36	$31.73	$21.90	1
Wyoming	33	$32.47	$19.05	2
Guam	15	$28.73	$16.71	1
District of Columbia	14	$36.66	$22.59	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
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.