How much does Medicare pay for CPT 92134?

Medicare allowed an average of $39.40 per service and paid $28.95 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $124.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92134?

Imaging of retina. It was billed 8,111,308 times to 4,373,805 Medicare beneficiaries by 27,541 providers in 2024.

Does 92134 pay differently in an office than a hospital?

Yes. The allowed amount averaged $39.78 in an office setting and $24.50 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 92134 most?

Ophthalmology, with 7,051,887 services from 13,276 clinicians. Next are Optometry, Physician Assistant, Nurse Practitioner.

CPT 92134

Imaging of retina

$39.40Medicare-allowed amount per service, averaged across 8,111,308 services

Providers submitted

$124.12

Asking price, not received

Medicare allowed

$39.40

The fee schedule figure

Medicare paid

$28.95

Balance is patient coinsurance

Providers submitted an average of $124.12 for this code and Medicare allowed $39.40 — 3.2× 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 $28.95 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $39.78
Hospital / facility: $24.50

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. 7,911,594 services were billed in an office setting and 199,714 in a facility.

Services: 8,111,308
Beneficiaries: 4,373,805
Providers billing it: 27,541
Total allowed: $319,585,535

What Medicare pays for CPT 92134

Across 8,111,308 services billed by 27,541 providers to 4,373,805 beneficiaries, Medicare allowed an average of $39.40 per service. That is 1.9 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 92134

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	7,051,887	3,446,915	$39.64	13,276
Optometry	1,045,743	917,666	$37.94	14,191
Physician Assistant	6,436	4,597	$25.03	36
Nurse Practitioner	1,678	1,225	$33.54	11
Neurology	1,265	973	$32.39	13
Gastroenterology	1,240	666	$40.48	1
Internal Medicine	1,218	811	$35.63	5
Pediatric Medicine	773	336	$37.94	1
General Surgery	754	325	$38.80	1
Family Practice	142	132	$34.32	2
Unknown Supplier/Provider Specialty	82	74	$38.72	2
Osteopathic Manipulative Medicine	68	63	$36.48	1
General Practice	22	22	$52.15	1

92134 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	889,719	$43.42	$27.91	2,202
Florida	668,406	$39.15	$28.54	1,646
New York	547,965	$43.71	$28.83	1,598
Texas	516,711	$38.93	$28.49	1,784
Pennsylvania	394,630	$39.37	$28.18	1,349
Illinois	336,522	$38.86	$28.08	1,101
Maryland	277,848	$41.60	$29.02	508
Massachusetts	246,276	$39.69	$26.99	704
Ohio	246,175	$35.99	$26.93	1,016
Virginia	234,328	$39.70	$28.53	704
New Jersey	220,403	$44.02	$29.33	724
North Carolina	213,870	$36.73	$28.06	804
Michigan	205,972	$37.43	$27.72	824
Arizona	199,955	$39.13	$28.21	563
Tennessee	182,600	$37.08	$28.72	636
Washington	170,669	$40.33	$27.36	705
Georgia	161,429	$38.29	$28.78	611
Indiana	155,723	$37.63	$28.43	675
Missouri	150,020	$37.80	$28.19	579
South Carolina	149,268	$37.88	$28.54	418
Colorado	131,287	$39.84	$28.03	455
Oregon	115,970	$39.23	$28.04	406
Wisconsin	114,766	$34.48	$25.23	641
Iowa	112,617	$35.40	$27.41	453
Minnesota	106,535	$39.01	$27.12	605
Louisiana	105,959	$34.18	$26.71	366
Kentucky	98,565	$36.76	$28.14	403
Oklahoma	97,094	$36.23	$27.65	476
Kansas	95,842	$36.90	$28.02	421
Alabama	90,174	$35.88	$28.50	405
Mississippi	83,651	$34.99	$27.67	280
Connecticut	74,887	$42.67	$29.09	321
Arkansas	72,322	$34.75	$27.73	312
Utah	71,291	$36.83	$27.62	241
Nevada	62,442	$39.54	$28.32	189
Nebraska	61,078	$35.01	$26.51	260
Montana	44,375	$39.22	$27.64	151
Idaho	42,590	$37.16	$28.36	190
South Dakota	37,583	$38.36	$27.87	164
West Virginia	35,311	$34.55	$26.60	157
Hawaii	35,262	$42.30	$27.94	160
New Mexico	33,076	$36.93	$27.46	160
New Hampshire	31,316	$38.84	$27.51	171
Delaware	30,516	$39.22	$28.43	110
Maine	30,446	$37.37	$27.31	184
North Dakota	30,085	$35.30	$24.66	156
Rhode Island	26,236	$39.86	$28.72	130
Vermont	17,145	$34.60	$24.53	89
Alaska	15,654	$46.57	$26.41	109
Wyoming	14,962	$39.02	$26.93	84
District of Columbia	12,060	$43.23	$28.91	46
Puerto Rico	7,429	$39.02	$27.84	76
AE	2,275	$37.61	$28.36	1
U.S. Virgin Islands	715	$38.49	$25.09	5
Guam	694	$41.59	$27.80	6
Northern Mariana Islands	314	$42.39	$26.03	3

Related codes

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
92100Multiple measurements of eye fluid pressure over an extended time peri$87.51

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.