How much does Medicare pay for CPT 92100?

Medicare allowed an average of $87.51 per service and paid $65.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $127.40, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92100?

Multiple measurements of eye fluid pressure over an extended time period. It was billed 17,800 times to 12,441 Medicare beneficiaries by 206 providers in 2024.

Does 92100 pay differently in an office than a hospital?

Yes. The allowed amount averaged $87.97 in an office setting and $31.07 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 92100 most?

Ophthalmology, with 10,534 services from 78 clinicians. Next are Optometry, Family Practice, Internal Medicine.

CPT 92100

Multiple measurements of eye fluid pressure over an extended time period

$87.51Medicare-allowed amount per service, averaged across 17,800 services

Providers submitted

$127.40

Asking price, not received

Medicare allowed

$87.51

The fee schedule figure

Medicare paid

$65.28

Balance is patient coinsurance

Providers submitted an average of $127.40 for this code and Medicare allowed $87.51 — 1.5× 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 $65.28 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $87.97
Hospital / facility: $31.07

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. 17,655 services were billed in an office setting and 145 in a facility.

Services: 17,800
Beneficiaries: 12,441
Providers billing it: 206
Total allowed: $1,557,678

What Medicare pays for CPT 92100

Across 17,800 services billed by 206 providers to 12,441 beneficiaries, Medicare allowed an average of $87.51 per service. That is 1.4 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 92100

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	10,534	6,602	$91.91	78
Optometry	5,733	4,363	$79.67	95
Family Practice	508	495	$88.24	9
Internal Medicine	432	420	$92.65	9
Nurse Practitioner	200	183	$70.34	9
Endocrinology	193	189	$88.55	1
Geriatric Medicine	80	79	$80.70	1
Cardiology	44	37	$97.79	1
Emergency Medicine	29	28	$94.81	1
Physician Assistant	25	23	$67.96	1
Physical Medicine and Rehabilitation	22	22	$66.87	1

92100 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	6,884	$95.21	$62.87	37
Texas	2,393	$77.29	$60.13	34
Florida	1,800	$81.84	$63.29	24
New York	1,679	$96.98	$64.29	19
North Carolina	870	$76.64	$63.66	10
Massachusetts	559	$90.90	$56.70	4
Pennsylvania	486	$72.47	$57.62	10
Maryland	400	$85.10	$58.36	3
New Jersey	398	$92.10	$62.14	8
Connecticut	326	$88.37	$58.58	8
Virginia	275	$84.50	$60.10	4
Oklahoma	221	$76.48	$63.10	4
Puerto Rico	203	$82.63	$64.58	3
Illinois	161	$83.07	$58.42	4
Washington	159	$97.82	$64.40	2
New Hampshire	127	$85.28	$60.06	3
West Virginia	110	$37.61	$29.32	2
Mississippi	98	$57.89	$58.02	3
Ohio	86	$65.03	$58.47	3
Alabama	79	$74.44	$62.03	3
Louisiana	75	$77.76	$60.81	2
Michigan	57	$78.57	$60.35	3
Arkansas	57	$67.23	$61.63	2
Indiana	46	$54.21	$59.17	2
District of Columbia	39	$90.22	$63.11	1
Kentucky	36	$69.13	$54.69	1
Hawaii	35	$96.71	$66.39	1
Kansas	35	$71.60	$65.74	1
Minnesota	34	$84.60	$59.95	1
South Carolina	28	$66.24	$56.57	1
Colorado	17	$82.24	$58.57	1
New Mexico	16	$77.96	$57.41	1
Montana	11	$88.70	$65.64	1

Related codes

92134Imaging of retina$39.40
92133Imaging of optic nerve$34.19
92136Measurement of corneal curvature and depth of eye$35.52
92132Imaging of front third of eye$30.37
92145Measurement of corneal pressure$11.44

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.