Top billers · Codes · 92004

Who bills 92004?

92004 is the CPT code for: New patient complete exam of visual system. In 2024, 25,728 providers billed 92004 1,523,496 times, with an estimated $145.0M paid by Medicare.

$149.64
2026 PFS national rate (office)
25,728
Providers billing it (2024)
1,523,496
Services billed
$145.0M
Est. Medicare paid
The fee

What does Medicare pay for 92004?

Medicare's 2026 Physician Fee Schedule national rate for 92004 is $149.64 in the office setting and $77.82 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$149.64
Facility rate$77.82
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $95.18 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 92004 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Jacob Shafran, ODOptometryBrooklyn, NY4,168$390K
2Ruben Carlson, ODOptometryTampa, FL2,180$244K
3Anahit Sahakyan, ODOptometryGlendale, CA2,167$262K
4Sharis Karapetian, O.DOptometryGranada Hills, CA2,006$233K
5Kevin Munson, O.D.OptometryAllen, TX1,761$169K

25,723 more providers billed 92004 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

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The breakdown

Where 92004 gets billed.

Top states by volume

California157,902 services
Florida131,114 services
New York130,996 services
Texas121,235 services
New Jersey61,815 services
Illinois60,348 services
Massachusetts52,385 services
Pennsylvania51,750 services

About this code

CMS descriptionNew patient complete exam of visual system
Code typeCPT (Level I HCPCS)
Providers billing it (2024)25,728
Services billed (2024)1,523,496
Avg. Medicare payment per service (2024)$95.18
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

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