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Describe a service in plain words, or type a CPT/HCPCS code.

Medicare Physician Fee Schedule Effective Locality 02302-01 CMS RVU26D Updated

CPT 92014 Medicare rate in Portland, OR

Full eye exam, returning patient in ZIPs including 97201, 97209, and 97214

The Medicare allowed amount is $136.39 in the Office (non-facility) setting and $64.03 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.

92014 Q4 2026
Locality-adjusted allowed amount
$136.39
in a doctor’s own office or clinic

Portland, OR flag Portland, OR (Locality 02302-01)

7.2% above the national baseline ($127.26)

CMS RVU26DOctober 1 – December 31, 2026revision 2

( Work1.42 × 1.016 + Practice exp.2.35 × 1.111 + Malpractice0.04 × 0.744 ) × Conv. factor$33.4009 = $136.39

row 11,662

F Work RVU

1.42

G Non‑facility PE RVU

2.35

K MP RVU

0.04

Z Conversion factor

33.4009

row 87

E Work GPCI

1.016

F PE GPCI

1.111

G MP GPCI

0.744

The Medicare allowed amount is $136.39 in the Office (non-facility) setting and $64.03 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.

Assumes a participating provider, no modifiers, the whole service, before sequestration.

Customize service date, participation, and modifiers Check service-location ZIP CMS sources and method

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What Medicare locality is Portland, OR in? Copy link

Portland, OR is in CMS payment locality Portland (02302-01). The same amount applies everywhere in it.

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

ZIP codes in this payment locality (119)

The CMS ZIP-to-locality crosswalk maps 119 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 4 span more than one locality and need ZIP+4 for an exact match.

97003 97004 97005 97006 97007 97008 97009 97010 97011 97013 97015 97017 97019 97022 97023 97024 97027 97028 97030 97034 97035 97036 97038 97042 97045 97049 97055 97060 97062 97067 97068 97070 97075 97076 97077 97078 97079 97080 97086 97089 97106 97109 97113 97116 97117 97119 97123 97124 97125 97129 97133 97140 97144 97200 97201 97202 97203 97204 97205 97206 97207 97208 97209 97210 97211 97212 97213 97214 97215 97216 97217 97218 97219 97220 97221 97222 97223 97224 97225 97227 97228 97229 97230 97231 97232 97233 97236 97238 97239 97240 97242 97250 97251 97252 97253 97254 97255 97256 97258 97259

19 more ZIP codes map to this locality. The Portland, OR locality page lists the full set.

Which ZIP codes does the Portland, OR rate for 92014 cover?

The CMS ZIP-to-locality crosswalk maps 119 ZIP codes to this payment locality, and 92014 has the same amount in every one of them. Examples include 97003, 97004, 97005, 97006, 97007, 97008. Of these, 4 span more than one payment locality and need ZIP+4 for an exact match.

How locality affects the amount Copy link

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

Portland, OR (this locality)
$136.39
National PFS baseline (GPCI 1.000)
$127.26

Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put Portland, OR 7.2% above the national baseline.

Portland, OR ranks #27 of 109 Medicare payment localities for 92014, where #1 has the highest allowed amount. Within Oregon it's #1 of 2: $9.84 (7.8%) higher than Rest of Oregon ($126.55).

Work GPCI
1.016
+$0.76 vs. national
Practice expense GPCI
1.111
+$8.71 vs. national
Malpractice GPCI
0.744
-$0.34 vs. national
2026 conversion factor
$33.4009

Each figure is that GPCI's share of the +$9.13 gap from the national baseline: its RVUs for 92014 × (GPCI − 1.000) × the conversion factor. Practice expense accounts for the most, +$8.71.

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Why is the 92014 rate in Portland, OR 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 1.016, practice expense 1.111, malpractice 0.744—scale each RVU component before the conversion factor is applied, which is why the Portland, OR amount is higher than the $127.26 baseline.

92014 in Portland, OR since Q4 2025 Copy link

Office (non-facility) · Participating · Whole service

The allowed amount went from $128.77 in Q4 2025 to $136.39 in Q4 2026, +$7.62 (+5.9%). The national baseline moved +5.2% over the same period.

What changed 92014's allowed amount in Portland, OR between Q4 2025 and Q4 2026
Conversion factor National: the dollar multiplier CMS sets each year. +$4.20
92014's RVUs National: CMS revalued the code itself. +$2.58
Portland, OR's GPCIs Local: this payment locality's cost indices. +$0.84
Total change +$7.62

A derived breakdown of the two releases' formula inputs, applied in order: the conversion factor on Q4 2025's RVUs and GPCIs, then 92014's new RVUs, then this locality's new GPCIs. A different order moves a few cents between rows; the total is exact.

Formula and inputs Copy link

For the office (non-facility) amount, each of 92014's RVU components is multiplied by its Portland, OR GPCI; the products are summed and multiplied by the conversion factor.

Code
92014
DOS
Not selected; uses this release’s rates
Locality
PORTLAND (OR)
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 Portland, OR allowed amount for 92014
Component RVU × GPCI = Adjusted
Work 1.42 × 1.016 1.4427
Practice expense · Office (non-facility) 2.35 × 1.111 2.6109
Malpractice 0.04 × 0.744 0.0298
Sum of adjusted RVUs 4.0833
× 33.4009 conversion factor = formula amount $136.39

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

  1. Locality-adjusted allowed amount $136.39

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • 92014’s RVUs, PFS status and conversion factor

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

    PPRRVU2026_Oct_nonQPP.csv row 11,662 in rvu26d-updated-08-26-2026.zip

    A HCPCS
    92014
    B Modifier
    blank
    D Status code
    A
    F Work RVU
    1.42
    G Non-facility PE RVU
    2.35
    K MP RVU
    0.04
    Z Conversion factor
    33.4009
    In the CMS file

    Loading rows 11,660–11,664 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

  • Locality 02302-01’s GPCIs

    Geographic practice cost indices (GPCI)CMS RVU26DOctober 1 – December 31, 2026revision 2

    GPCI2026.csv row 87 in rvu26d-updated-08-26-2026.zip

    A MAC
    02302
    C Locality number
    01
    E Work GPCI
    1.016
    F PE GPCI
    1.111
    G MP GPCI
    0.744
    In the CMS file

    Loading rows 85–89 of GPCI2026.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264

CMS RVU26DOctober 1 – December 31, 2026revision 2

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient department or ASC), the allowed amount for 92014 in Portland, OR is $64.03, versus $136.39 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 92014 in Portland, OR?

$64.03 in a facility, versus $136.39 in the Office (non-facility) setting—a $72.36 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 Portland, OR. 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 92014 in Portland, OR
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $136.39
Non-participating allowed amount 95% of the participating amount. $129.57
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $149.01
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $109.11
Patient coinsurance The remaining 20%. $27.28
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $2.18
Net Medicare payment Medicare's share after the sequestration reduction. $106.93
What is the non-participating amount and limiting charge for 92014 in Portland, OR?

A non-participating provider is paid $129.57—95% of the $136.39 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $149.01, which is 115% of the non-participating amount.

How much of the Portland, OR 92014 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($109.11) once the annual Part B deductible is met, and the beneficiary owes 20% ($27.28). Sequestration reduces Medicare's share by about 2% ($2.18), leaving $106.93. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Portland, OR 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—$136.39 in the office (non-facility) setting—not the $127.26 national baseline.

Opens the calculator set to Portland, OR 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.

92014 in nearby payment localities Copy link

Payment localities in the same region as Portland, OR, nearest first. Each amount is that locality's own GPCI-adjusted Office (non-facility) figure for 92014. Neighboring localities often differ.

Percentages are against Portland, OR. Every payment locality nationwide is on the CPT 92014 rate map.

Other codes priced in Portland, OR Copy link

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

Other curated codes and their allowed amounts in Portland, OR
Code and service Allowed vs. national
99213 Routine Follow-Up Office Visit $100.53 +5.6%
99214 Long Follow-Up Office Visit $142.85 +5.3%
66984 Cataract Surgery $484.58 +4.8%
99204 Long New Patient Office Visit $185.85 +4.8%
99215 Longest Follow-Up Office Visit $202.29 +5.1%
97110 Physical Therapy Exercises $30.73 +5.7%
99203 New Patient Office Visit $123.58 +5.1%
93000 Heart Tracing $16.29 +6.1%
93306 Heart Ultrasound $213.08 +8.3%
77067 Screening Mammogram $137.31 +8.8%
27447 Knee Replacement $1,178.12 +1.6%
70450 Head CT Without Contrast $115.01 +7.9%

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 02302-01'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.

Working a claim with an earlier date of service? The calculator prices 92014 in Portland, OR against the release in effect on that date. Dates of service this quarter don't need an account; earlier dates need a free account.

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