Top billers · Codes · 92012

Who bills 92012?

92012 is the CPT code for: Established patient problem focused exam of visual system. In 2024, 15,822 providers billed 92012 3,111,523 times, with an estimated $198.9M paid by Medicare.

$90.52
2026 PFS national rate (office)
15,822
Providers billing it (2024)
3,111,523
Services billed
$198.9M
Est. Medicare paid
The fee

What does Medicare pay for 92012?

Medicare's 2026 Physician Fee Schedule national rate for 92012 is $90.52 in the office setting and $41.42 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$90.52
Facility rate$41.42
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $63.93 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 92012 the most.

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

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Gregory Harmon, MDOphthalmologyNew York, NY4,321$282K
2Omesh Gupta, MDOphthalmologyPlymouth Meeting, PA4,246$309K
3Craig Fern, M.D.OphthalmologyMount Kisco, NY4,243$337K
4Paul Guerriero, M.D.OphthalmologyOrangeburg, NY3,797$250K
5Carl Regillo, MDOphthalmologyPlymouth Meeting, PA3,712$264K

15,817 more providers billed 92012 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 92012 gets billed.

Top states by volume

California501,718 services
New York376,510 services
Florida275,388 services
Texas274,013 services
New Jersey202,902 services
Pennsylvania184,006 services
Illinois113,593 services
Massachusetts96,667 services

About this code

CMS descriptionEstablished patient problem focused exam of visual system
Code typeCPT (Level I HCPCS)
Providers billing it (2024)15,822
Services billed (2024)3,111,523
Avg. Medicare payment per service (2024)$63.93
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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