FairBillCheck

CPT 92134: what Medicare pays in 2026

Eye exam or test

Medicare's 2026 national amount for 92134 is $32.73 when a doctor's office or clinic bills it. Across Medicare's 109 payment localities the office amount runs from $29.35 in Arkansas to $43.16 in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

CPT descriptions are copyrighted by the American Medical Association, so this page shows the code number only. The description printed on your bill, or the provider, will tell you what the code covers.

Medicare amounts for 92134 in 2026

Doctor's office or clinic, national
$32.73
Professional part only (modifier 26), office, national
$17.70
Technical part only (modifier TC), office, national
$15.03
Hospital outpatient rate, national (APC 5733)
$60.27
Hospital outpatient status Q1
packaged when billed with a separately paid procedure or visit, otherwise paid

Hospital outpatient rates are national figures before Medicare's wage adjustment, which moves about 60% of the rate up or down with local hospital wages.

What providers charged Medicare for 92134 in 2024

From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.

SettingServicesAverage chargeMedicare allowedCharge vs allowed
In an office or other non-facility setting7,967,596$124.33$39.773.1×
In a facility setting204,262$108.67$24.514.4×

How Medicare builds the 92134 amount

Each physician fee schedule amount is three relative value units (RVUs), each multiplied by the locality's cost index, added up and multiplied by the 2026 conversion factor of $33.4009.

Work RVU
0.31
Practice expense RVU, office
0.65
Malpractice RVU
0.02

92134 in every Medicare locality

The office amount is lowest in Arkansas and highest in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

StateLocalityOfficeFacility
AKAlaska$39.02none
ALAlabama$29.73none
ARArkansas$29.35none
AZArizona$31.96none
CABakersfield$34.75none
CAChico$34.68none
CAEl Centro$34.69none
CAFresno$34.68none
CAHanford-Corcoran$34.68none
CALos Angeles-Long Beach-Anaheim (Los Angeles/Orange County)$36.91none
CAMadera$34.68none
CAMerced$34.68none
CAModesto$34.68none
CANapa$39.96none
CAOxnard-Thousand Oaks-Ventura$36.72none
CARedding$34.68none
CARest of California$34.68none
CARiverside-San Bernardino-Ontario$34.91none
CASacramento-Roseville-Folsom$36.33none
CASalinas$36.20none
CASan Diego-Chula Vista-Carlsbad$36.99none
CASan Francisco-Oakland-Berkeley (Marin County)$42.26none
CASan Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)$42.23none
CASan Jose-Sunnyvale-Santa Clara (San Benito County)$43.16none
CASan Jose-Sunnyvale-Santa Clara (Santa Clara County)$43.07none
CASan Luis Obispo-Paso Robles$35.62none
CASanta Cruz-Watsonville$37.31none
CASanta Maria-Santa Barbara$36.32none
CASanta Rosa-Petaluma$37.68none
CAStockton$34.68none
CAVallejo$39.93none
CAVisalia$34.68none
CAYuba City$34.68none
COColorado$34.10none
CTConnecticut$34.75none
DCDC + MD/VA Suburbs$37.23none
DEDelaware$32.46none
FLFort Lauderdale$33.55none
FLMiami$34.64none
FLRest of Florida$32.11none
GAAtlanta$33.25none
GARest of Georgia$30.52none
HIHawaii, Guam$35.43none
IAIowa$30.48none
IDIdaho$30.64none
ILChicago$33.78none
ILEast St. Louis$31.67none
ILRest of Illinois$31.22none
ILSuburban Chicago$33.91none
INIndiana$30.80none
KSKansas$30.32none
KYKentucky$30.27none
LANew Orleans$31.54none
LARest of Louisiana$30.21none
MAMetropolitan Boston$37.30none
MARest of Massachusetts$33.91none
MDBaltimore/Surrounding Counties$34.64none
MDRest of Maryland$33.04none
MERest of Maine$30.74none
MESouthern Maine$32.29none
MIDetroit$32.43none
MIRest of Michigan$30.93none
MNMinnesota$32.89none
MOMetropolitan Kansas City$31.39none
MOMetropolitan St. Louis$31.69none
MORest of Missouri$29.72none
MSMississippi$29.54none
MTMontana$32.73none
NCNorth Carolina$31.04none
NDNorth Dakota$32.34none
NENebraska$30.65none
NHNew Hampshire$33.54none
NJNorthern NJ$36.90none
NJRest of New Jersey$35.21none
NMNew Mexico$31.07none
NVNevada$32.64none
NYManhattan$37.30none
NYNYC Suburbs/Long Island$38.07none
NYPoughkeepsie/Northern NYC Suburbs$35.40none
NYQueens$37.64none
NYRest of New York$31.45none
OHOhio$30.85none
OKOklahoma$30.26none
ORPortland$35.14none
ORRest of Oregon$32.45none
PAMetropolitan Philadelphia$33.94none
PARest of Pennsylvania$30.92none
PRPuerto Rico$32.96none
RIRhode Island$33.57none
SCSouth Carolina$30.98none
SDSouth Dakota$32.29none
TNTennessee$30.45none
TXAustin$33.94none
TXBeaumont$30.73none
TXBrazoria$32.47none
TXDallas$32.64none
TXFort Worth$32.44none
TXGalveston$32.55none
TXHouston$32.91none
TXRest of Texas$31.56none
UTUtah$31.36none
VAVirginia$32.17none
VIVirgin Islands$32.96none
VTVermont$32.19none
WARest of Washington$33.86none
WASeattle (King County)$38.06none
WIWisconsin$31.36none
WVWest Virginia$30.18none
WYWyoming$32.56none

Other eye exam or test codes