# CPT 92004

> CMS published national PFS baselines of $149.64 in the office (non-facility) setting and $77.82 in a facility for CPT 92004 in the Q4 2026 Physician Fee Schedule. These figures take effect for dates of service beginning Oct 1, 2026. Across payment localities, the office amount is $136.65–$194.38 and the facility amount is $74.96–$108.64. This price has been unchanged since Q1 2026, when it increased 4.7%.

## What it is

New Patient Eye Examination, Comprehensive

## Selected release

- Release: Q4 2026 (2026 D)
- Effective: October 1 – December 31, 2026
- Status indicator: A
- Office (non-facility) national allowed amount: $149.64
- Facility national allowed amount: $77.82
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.82
- Office (non-facility) practice expense RVU: 2.62
- Facility practice expense RVU: 0.47
- Malpractice RVU: 0.04
- Conversion factor: 33.4009
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## NCCI edits

- Never-billable pair count: 99
- Modifier-allowed pair count: 19
- MUE units per patient per date of service: not published
- Complete list: https://localishealth.com/cpt/92004/2026/D/ncci-edits.txt

## Source and citation

- Source: Physician relative value file (Q4 2026)
- CMS file: https://www.cms.gov/files/zip/rvu26d-updated-08-26-2026.zip
- Parsed file: PPRRVU2026_Oct_nonQPP.csv, row 11,660
- Canonical page: https://localishealth.com/cpt/92004/2026/A
- Release-specific citation URL: https://localishealth.com/cpt/92004/2026/D
- Last significant update: 2026-09-01T06:33:29+00:00