CPT 92012

Oph Svcs Medical Xm&Eval Intermediate Est Pt

CPT 92012 pays $90.52 in a non-facility setting and $41.42 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $81.74 in Arkansas to $109.25 in Alaska, a 34% spread.

National non-facility rate

$90.52

Office and other outpatient settings

Facility rate
$41.42

Hospital and ASC settings

Highest state
$109.25

Alaska

Lowest state
$81.74

Arkansas · 34% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $90.52
CPT 92012 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $90.52, national facility $41.42.
StateRate compared visuallyNon-facilityFacility
Alaska
$109.25$56.96
District of Columbia
$102.75$44.91
California
$101.93$43.83
New Jersey
$99.59$44.30
Washington
$99.50$43.53
New York
$99.13$44.35
Massachusetts
$98.50$43.33
Hawaii
$98.15$42.32
Connecticut
$95.87$42.99
Colorado
$94.43$42.19
Oregon
$93.63$41.90
Maryland
$93.49$42.31
Rhode Island
$92.93$42.21
New Hampshire
$92.80$41.69
Florida
$91.66$42.40
Minnesota
$91.52$40.99
Puerto Rico
$91.15$41.51
Virgin Islands
$91.15$41.51
Montana
$90.51$41.42
Nevada
$90.41$41.26
Wyoming
$90.26$41.16
North Dakota
$89.92$40.82
Delaware
$89.86$41.35
South Dakota
$89.85$40.75
Texas
$89.70$41.36
Pennsylvania
$89.66$41.56
Illinois
$89.55$42.11
Vermont
$89.43$40.83
Virginia
$89.22$40.96
Arizona
$88.55$40.97
Georgia
$88.06$41.21
Maine
$87.53$40.61
Wisconsin
$87.35$40.32
Michigan
$87.34$41.23
Utah
$86.89$40.73
North Carolina
$86.22$40.41
South Carolina
$85.90$40.53
New Mexico
$85.84$40.81
Indiana
$85.71$40.19
Missouri
$85.66$40.60
Louisiana
$85.45$40.62
Ohio
$85.41$40.58
Nebraska
$85.37$40.05
Idaho
$85.29$40.11
Iowa
$84.92$39.99
Tennessee
$84.70$40.07
Kansas
$84.38$39.99
Oklahoma
$84.00$40.16
Kentucky
$83.91$40.26
West Virginia
$83.25$40.58
Alabama
$82.73$39.77
Mississippi
$82.08$39.81
Arkansas
$81.74$39.57

Billed by 2 specialties

Commercial rates for 92012

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates