Eye & ear

92012 - RVUs & Medicare payment (2026)

Eye exam, established patient, intermediate.

Component	Non-facility	Facility
Work RVU	0.92	0.92
Practice expense RVU	1.76	0.29
Malpractice RVU	0.03	0.03
Total RVUs	2.71	1.24
National payment (CF $33.4009)	$90.52	$41.42
Qualifying APM payment (CF $33.5675)	$90.97	$41.62

How 92012 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 92012 ranges from $81.74 in Arkansas (AR) to $119.41 in San Jose-Sunnyvale-Santa Clara (CA); calculate 92012 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $119.41 San Jose-Sunnyvale-Santa Clara (CA) $119.28 San Francisco-Oakland-Berkeley (CA) $117.00 San Francisco-Oakland-Berkeley (CA) $116.96 Napa (CA) $110.65 Vallejo (CA) $110.60 Alaska (AK) $109.25 Seattle (WA) $105.21 National average $90.52 … 97 more localities between … Alabama (AL) $82.73 Rest Of Missouri (MO) $82.38 Mississippi (MS) $82.08 Arkansas (AR) $81.74

Non-facility payment for 92012 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - eye & ear

92002 · eye exam, new patient, intermediate
92004 · eye exam, new patient, comprehensive
92014 · eye exam, established patient, comprehensive
92083 · visual field examination, extended
92134 · optical coherence tomography (oct), retina
66984 · cataract removal with intraocular lens insertion
92557 · comprehensive hearing test (audiometry)

Frequently asked questions

How much does Medicare pay for 92012 in 2026?

The national non-facility payment is $90.52 and the facility payment is $41.42, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 92012?

The 2026 work RVU for 92012 is 0.92. Total RVUs are 2.71 in the non-facility setting and 1.24 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.