{
    "code": "92012",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/92012/2022/A",
    "release_specific_url": "https://localishealth.com/cpt/92012/2022/C",
    "description": "An eye examination for a patient the practice has seen before, at the middle level of detail. It typically involves evaluating a new or continuing problem, checking vision and eye pressure, examining the front of the eye, and updating the diagnosis and plan, along with any needed prescription changes. The step up from this is the comprehensive exam, which adds a full evaluation of the whole visual system, usually including a dilated look at the retina and optic nerve. Eye clinicians can use either this eye-specific family of codes or the general office visit codes, depending on what was done.",
    "answer": {
        "question": "How much did Medicare pay for CPT 92012 in Q3 2022?",
        "text": "Medicare paid $90.67 for CPT 92012 in the office (non-facility) setting and $51.22 in a facility under the Q3 2022 Physician Fee Schedule, effective July 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it decreased 0.4%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2022,
        "quarter": "C",
        "label": "Q3 2022",
        "effective": "July 1 – September 30, 2022",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 90.67,
        "facility": 51.22,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.92,
        "practice_expense_non_facility": 1.66,
        "practice_expense_facility": 0.52,
        "malpractice": 0.04
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.6062,
    "source": {
        "label": "Physician relative value file (Q3 2022)",
        "cms_url": "https://www.cms.gov/files/zip/rvu22c-updated-06172022.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2022/C",
        "file": "PPRRVU22_JUL.csv",
        "row": 16227,
        "sha256": "f0a493a192a21b1faa980aa71d22c8ae064e87b564f51a67e1229fcee376df41"
    },
    "modified_at": "2026-08-04T03:11:49+00:00"
}