How much does Medicare pay for CPT 92284?

Medicare allowed an average of $34.27 per service and paid $23.86 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $99.31, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92284?

Evaluation of eye adaptation to light and dark with interpretation and report. It was billed 27,090 times to 23,423 Medicare beneficiaries by 416 providers in 2024.

Which specialty bills 92284 most?

Optometry, with 22,178 services from 375 clinicians. Next are Ophthalmology, Audiologist.

CPT 92284

Evaluation of eye adaptation to light and dark with interpretation and report

$34.27Medicare-allowed amount per service, averaged across 27,090 services

Providers submitted

$99.31

Asking price, not received

Medicare allowed

$34.27

The fee schedule figure

Medicare paid

$23.86

Balance is patient coinsurance

Providers submitted an average of $99.31 for this code and Medicare allowed $34.27 — 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 $23.86 (70%); the rest is the patient’s coinsurance and deductible.

Services: 27,090
Beneficiaries: 23,423
Providers billing it: 416
Total allowed: $928,374

What Medicare pays for CPT 92284

Across 27,090 services billed by 416 providers to 23,423 beneficiaries, Medicare allowed an average of $34.27 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 92284

Specialty	Services	Beneficiaries	Avg allowed	Providers
Optometry	22,178	19,296	$33.35	375
Ophthalmology	4,823	4,080	$38.32	40
Audiologist	89	47	$43.62	1

92284 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	2,942	$41.21	$24.40	21
Pennsylvania	2,014	$32.50	$23.29	42
New Jersey	1,580	$38.45	$26.20	17
Florida	1,526	$35.15	$26.05	17
North Carolina	1,490	$31.08	$24.10	14
Texas	1,330	$34.20	$24.84	28
Illinois	1,098	$34.49	$24.68	21
Kansas	1,049	$33.36	$25.38	12
Missouri	1,045	$31.53	$24.49	12
Ohio	973	$32.49	$25.05	16
New York	823	$36.10	$23.98	9
Tennessee	819	$29.99	$24.16	20
Oklahoma	728	$27.73	$23.48	13
Alabama	727	$31.21	$24.59	10
Mississippi	610	$28.18	$24.91	9
Virginia	588	$35.70	$24.76	15
Arizona	539	$35.73	$24.69	5
Louisiana	512	$30.07	$24.90	6
Alaska	509	$39.31	$21.50	8
Oregon	477	$36.96	$26.25	9
Arkansas	447	$28.74	$24.69	5
Idaho	439	$27.21	$23.51	3
Iowa	434	$33.47	$23.48	8
Maryland	411	$33.74	$22.87	7
Hawaii	392	$38.45	$23.79	10
Nevada	388	$34.92	$24.40	4
Nebraska	373	$34.66	$22.66	6
Michigan	362	$32.31	$23.44	5
Georgia	336	$30.88	$26.09	7
Wyoming	327	$36.06	$22.42	4
Indiana	281	$33.09	$24.58	8
South Carolina	243	$32.93	$24.20	3
Colorado	206	$39.10	$22.98	8
Massachusetts	185	$37.14	$25.52	4
Wisconsin	170	$32.88	$21.76	3
Kentucky	130	$26.51	$20.65	3
North Dakota	129	$36.56	$24.32	4
Minnesota	112	$36.66	$21.75	4
West Virginia	96	$30.97	$24.19	3
Washington	68	$36.74	$22.67	3
Utah	49	$34.16	$24.24	3
New Mexico	43	$29.22	$20.72	2
New Hampshire	33	$38.29	$24.55	2
Maine	26	$33.39	$23.14	1
South Dakota	18	$35.94	$25.33	1
Connecticut	13	$35.75	$26.09	1

Related codes

92250Photography of the retina$35.91
92202Extended exam of the back part of the eye$15.95
92201Extended exam of the back part of the eye$25.70
92285Photography of content of eyes$21.67
92235Exam of retinal blood vessels$162.79
92273Measurement of retinal and optic nerve function$122.61
92286Imaging of front third of eye$38.45
92283Extended exam involving color vision testing$49.33
92242Exam of retinal blood vessels and blood vessels between the white part$289.54
92228Imaging of retina$23.67
92240Exam of blood vessels between the white part of eye and retina$181.64
92287Imaging of front third of eye$154.40

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.