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Medicare Physician Fee Schedule · Q4 2026 release

CPT 92012 in Anchorage, AK

Established patient eye examination, intermediate in ZIPs including 99501, 99503, and 99507

92012 Q4 2026 · Anchorage, AK flag02102-01
Locality-adjusted allowed amount
$109.25
in a doctor’s own office or clinic

120.7% of the $90.52 national baseline

( Work0.92 × 1.500 + Practice exp.1.76 × 1.065 + Malpractice0.03 × 0.551 ) × Conv. factor$33.4009 = $109.25

The Medicare allowed amount is $109.25 in the Office (non-facility) setting and $56.96 in a facility, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.

Q4 2026 · Locality 02102-01 · Participating · Whole service · Sequestration excluded

CMS sources and method · Calculation inputs

Calculate with this locality Check service-location ZIP

What Medicare locality is Anchorage, AK in? Copy link

CMS prices all of Alaska as one Medicare payment locality, so this amount applies statewide, including Fairbanks and Juneau—not only in Anchorage, AK.

Confirm the locality before using this amount. A split ZIP needs ZIP+4 for an exact match.

ZIP codes in this payment locality (276)

The CMS ZIP-to-locality crosswalk maps 276 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality.

99501 99502 99503 99504 99505 99506 99507 99508 99509 99510 99511 99512 99513 99514 99515 99516 99517 99518 99519 99520 99521 99522 99523 99524 99529 99530 99540 99545 99546 99547 99548 99549 99550 99551 99552 99553 99554 99555 99556 99557 99558 99559 99561 99563 99564 99565 99566 99567 99568 99569 99571 99572 99573 99574 99575 99576 99577 99578 99579 99580 99581 99583 99584 99585 99586 99587 99588 99589 99590 99591 99599 99602 99603 99604 99605 99606 99607 99608 99609 99610 99611 99612 99613 99614 99615 99619 99620 99621 99622 99623 99624 99625 99626 99627 99628 99629 99630 99631 99632 99633

176 more ZIP codes map to this locality. The Anchorage, AK locality page lists the full set.

Which ZIP codes does the Anchorage, AK rate for 92012 cover?

The CMS ZIP-to-locality crosswalk maps 276 ZIP codes to this payment locality, and 92012 has the same amount in every one of them. Examples include 99501, 99502, 99503, 99504, 99505, 99506.

Does this 92012 rate apply everywhere in Alaska?

Yes. CMS prices Alaska as a single Medicare payment locality, so the same GPCIs—and the same allowed amount—apply statewide, not only in Anchorage, AK. That includes Fairbanks and Juneau. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.

How locality affects the amount Copy link

Office (non-facility) · Q4 2026 · Participating · Whole service

Anchorage, AK (this locality)
$109.25
National PFS baseline (GPCI 1.000)
$90.52

Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put Anchorage, AK 20.7% above the national baseline.

Work GPCI
1.500
Practice expense GPCI
1.065
Malpractice GPCI
0.551
2026 conversion factor
$33.4009
Why is the 92012 rate in Anchorage, AK different from the national amount?

The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices—work 1.500, practice expense 1.065, malpractice 0.551—scale each RVU component before the conversion factor is applied, which is why the Anchorage, AK amount is higher than the $90.52 baseline.

Formula and inputs Copy link

For the office (non-facility) amount, each of 92012's RVU components is multiplied by its Anchorage, AK GPCI; the products are summed and multiplied by the conversion factor.

Code
92012
DOS
Not selected; uses this release’s rates
Locality
ALASKA* (AK)
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q4 2026, revision 2
Sequestration
Shown separately from the allowed amount

Formula

(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor

Localis calculated this from CMS’s published inputs. Select an underlined value to see where it comes from.

RVU × GPCI components of Anchorage, AK allowed amount for 92012
Component RVU × GPCI = Adjusted
Work 0.92 × 1.500 1.3800
Practice expense · Office (non-facility) 1.76 × 1.065 1.8744
Malpractice 0.03 × 0.551 0.0165
Sum of adjusted RVUs 3.2709
× 33.4009 conversion factor = formula amount $109.25

Component subtotals show four decimals. The formula amount is rounded to cents before any later adjustment.

  1. Locality-adjusted allowed amount $109.25

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • Supplies the RVUs and PFS status for this code and component.

    Physician relative value file (PPRRVU)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 11,661)
    hcpcs (col 1)
    92012
    modifier (col 2)
    blank
    status_code (col 4)
    A
    work_rvu (col 6)
    0.92
    pe_rvu_nonfacility (col 7)
    1.76
    pe_rvu_facility (col 9)
    0.29
    mp_rvu (col 11)
    0.03

    SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

    Original source file

  • Supplies the geographic adjustment factors for this locality.

    Geographic practice cost indices (GPCI)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details GPCI2026.csv in rvu26d-updated-08-26-2026.zip (row 5)
    mac (col 1)
    02102
    locality_code (col 3)
    01
    work_gpci (col 5)
    1.5
    pe_gpci (col 6)
    1.065
    mp_gpci (col 7)
    0.551

    SHA-256: 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264

    Original source file

  • Supplies the dollar conversion factor used in the formula.

    Physician relative value file (PPRRVU)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 11)
    conversion_factor (col 26)
    33.4009

    SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

    Original source file

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient department or ASC), the allowed amount for 92012 in Anchorage, AK is $56.96, versus $109.25 in the Office (non-facility) setting. Only the practice-expense RVU changes with the setting: the facility bills its own fee for overhead, so the professional amount is lower. See which setting applies to your place of service.

What is the Facility amount for 92012 in Anchorage, AK?

$56.96 in a facility, versus $109.25 in the Office (non-facility) setting—a $52.29 difference. Only the practice-expense RVU changes with the setting: in the Office (non-facility) setting the practice carries the overhead, so the professional amount is higher; in a hospital or ASC the facility bills its own fee.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Anchorage, AK. Medicare pays part of the allowed amount and the patient pays the rest; the rows below show each figure. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 92012 in Anchorage, AK
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $109.25
Non-participating allowed amount 95% of the participating amount. $103.79
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $119.36
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $87.40
Patient coinsurance The remaining 20%. $21.85
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $1.75
Net Medicare payment Medicare's share after the sequestration reduction. $85.65
What is the non-participating amount and limiting charge for 92012 in Anchorage, AK?

A non-participating provider is paid $103.79—95% of the $109.25 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $119.36, which is 115% of the non-participating amount.

How much of the Anchorage, AK 92012 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($87.40) once the annual Part B deductible is met, and the beneficiary owes 20% ($21.85). Sequestration reduces Medicare's share by about 2% ($1.75), leaving $85.65. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Anchorage, AK Copy link

Commercial contracts are often written as a percentage of the Medicare fee schedule. The part that gets misread is which Medicare amount: a contract benchmarked to the fee schedule prices off this locality's allowed amount—$109.25 in the office (non-facility) setting—not the $90.52 national baseline.

Opens the calculator set to Anchorage, AK and your selected setting, where you can also compare what a payer paid against the expected amount. See how to find your contract's actual percentage.

Compare 92012 in comparable metros

Metros whose Office (non-facility) amount for 92012 sits closest to Anchorage, AK's, highest first. Each is that payment locality's own GPCI-adjusted amount.

92012 allowed amount in metros comparable to Anchorage, AK
Metro Allowed amount vs. Anchorage, AK
San Francisco, CA $116.96 +7.1%
Seattle, WA $105.21 -3.7%
Long Island, NY $104.45 -4.4%
Queens, NY $103.62 -5.2%
Boston, MA $103.07 -5.7%
Washington, DC $102.75 -5.9%
New York City, NY $102.59 -6.1%
San Diego, CA $102.50 -6.2%
Los Angeles, CA $102.20 -6.5%
Northern New Jersey, NJ $101.93 -6.7%
Ventura County, CA $101.70 -6.9%
Sacramento, CA $100.74 -7.8%

Every payment locality nationwide is on the CPT 92012 rate map.

Other codes priced in Anchorage, AK Copy link

Office (non-facility) allowed amounts in this same payment locality, Q4 2026.

Other curated codes and their allowed amounts in Anchorage, AK
Code and service Allowed vs. national
92014 Full Eye Exam, Returning Patient $155.47 +22.2%
92004 New Patient Eye Examination, Comprehensive $185.12 +23.7%
67028 Intravitreal Medication Injection $140.11 +22.7%
92134 Retina Scan $39.02 +19.2%
99213 Routine Follow-Up Office Visit $118.72 +24.7%
99214 Long Follow-Up Office Visit $169.92 +25.3%
66984 Cataract Surgery $587.58 +27.0%
99204 Long New Patient Office Visit $222.54 +25.5%
99212 Brief Follow-Up Office Visit $72.46 +21.9%
99215 Longest Follow-Up Office Visit $241.97 +25.8%
97110 Physical Therapy Exercises $37.31 +28.4%
99203 New Patient Office Visit $145.71 +23.9%

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q4 2026 release: this code's RVUs from the relative value file, multiplied by payment locality 02102-01's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q4 2026 release. Past releases are never edited, so an amount for an earlier quarter always matches what CMS published for it. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 11,661)
Geographic practice cost indices (Q4 2026) · rvu26d-updated-08-26-2026.zip (GPCI2026.csv row 5)
ZIP code to carrier locality crosswalk (Q4 2026) · zip-code-carrier-locality-file-updated-08-13-2026.zip (ZIP5_OCT2026.txt)

Working a claim with an earlier date of service? The calculator prices 92012 in Anchorage, AK against the release in effect on that date. Dates in the last 12 months don't need an account; older dates of service need a free account.

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