Cost analysis for CPT 92004 — New patient complete exam of visual system
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 1.6x more than the cheapest for this procedure. NY averages $115.33 vs MP at $70.66.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $115.33 | $16.1M | 139.2K | 1.7K |
| NJ | $112.48 | $7.2M | 64.1K | 904 |
| CA | $111.33 | $18.9M | 169.4K | 1.9K |
| CT | $105.64 | $2.1M | 20.0K | 407 |
| AK | $103.87 | $327.5K | 3.2K | 79 |
| MD | $103.43 | $3.4M | 32.7K | 472 |
| DC | $102.22 | $146.5K | 1.4K | 25 |
| MA | $99.90 | $5.6M | 55.6K | 885 |
| RI | $97.91 | $476.0K | 4.9K | 120 |
| PR | $97.00 | $213.2K | 2.2K | 74 |
| FL | $96.58 | $13.5M | 139.4K | 1.7K |
| IL | $96.03 | $6.3M | 65.4K | 991 |
| PA | $95.16 | $5.2M | 55.2K | 1.1K |
| VA | $94.19 | $4.0M | 42.8K | 680 |
| DE | $93.17 | $526.2K | 5.6K | 88 |
| TX | $93.15 | $12.6M | 135.1K | 2.1K |
| HI | $92.84 | $409.0K | 4.4K | 107 |
| WA | $92.51 | $3.2M | 34.4K | 611 |
| NH | $92.00 | $893.9K | 9.7K | 177 |
| AZ | $91.75 | $3.3M | 36.0K | 512 |
| GA | $91.39 | $3.8M | 41.1K | 641 |
| NV | $91.08 | $1.1M | 11.9K | 226 |
| CO | $91.02 | $2.1M | 23.3K | 480 |
| MI | $90.17 | $2.9M | 32.0K | 685 |
| NC | $89.86 | $2.8M | 31.3K | 616 |
| OR | $88.65 | $1.6M | 18.2K | 333 |
| IN | $88.56 | $2.2M | 24.7K | 504 |
| MO | $88.40 | $2.4M | 27.7K | 532 |
| VT | $88.38 | $513.2K | 5.8K | 87 |
| TN | $88.33 | $2.9M | 32.3K | 601 |
| SD | $88.31 | $797.0K | 9.0K | 171 |
| SC | $88.15 | $2.5M | 28.5K | 446 |
| MN | $88.14 | $2.0M | 22.3K | 588 |
| AL | $86.99 | $1.3M | 14.4K | 303 |
| OH | $86.78 | $3.6M | 41.0K | 915 |
| LA | $86.26 | $2.1M | 24.1K | 379 |
| OK | $86.12 | $2.3M | 27.0K | 433 |
| AR | $85.89 | $1.9M | 22.2K | 309 |
| KS | $85.69 | $1.9M | 21.6K | 414 |
| KY | $85.57 | $1.5M | 17.2K | 340 |
| NE | $85.48 | $1.1M | 12.8K | 224 |
| ME | $85.28 | $691.0K | 8.1K | 192 |
| MS | $85.14 | $2.1M | 24.1K | 326 |
| MT | $84.53 | $657.1K | 7.8K | 148 |
| GU | $84.48 | $31.5K | 373 | 7 |
| UT | $84.23 | $1.1M | 13.0K | 252 |
| IA | $83.56 | $1.6M | 19.3K | 408 |
| WV | $83.27 | $686.2K | 8.2K | 146 |
| ND | $83.19 | $453.6K | 5.5K | 138 |
| WY | $82.78 | $289.2K | 3.5K | 75 |
| ID | $82.45 | $784.9K | 9.5K | 180 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Jacob Shafran | Optometry | NY | $447.1K | 3.5K | $128.16 |
| Anahit Sahakyan | Optometry | CA | $308.9K | 2.4K | $129.62 |
| Orysya Protas | Optometry | NY | $241.7K | 1.8K | $132.39 |
| Liann Griffiths | Optometry | CA | $220.8K | 1.7K | $129.11 |
| Sharis Gharabeki | Optometry | CA | $215.9K | 1.6K | $131.95 |
| Greta Torossian | Optometry | CA | $212.6K | 1.6K | $129.69 |
| Jerry Weinberg | Ophthalmology | NY | $208.2K | 1.5K | $135.60 |
| Lori Birndorf | Ophthalmology | CA | $193.9K | 1.5K | $130.02 |
| Teresa Lim | Optometry | CA | $193.5K | 1.4K | $136.26 |
| Kevin Munson | Optometry | TX | $178.4K | 1.6K | $108.30 |
| David Lelonek | Optometry | NY | $176.9K | 1.3K | $135.44 |
| Aashay Shah | Optometry | IL | $160.0K | 1.2K | $134.31 |
| Richard Bransgrove | Optometry | FL | $154.8K | 1.3K | $119.71 |
| David Swearingen | Optometry | CA | $153.0K | 1.2K | $127.60 |
| Tiffany Chuang | Optometry | CA | $147.7K | 1.0K | $144.95 |
| Lori Moore | Ophthalmology | CA | $142.0K | 1.1K | $132.22 |
| Yanara Barreras | Optometry | FL | $134.5K | 1.1K | $119.46 |
| Edward Deneve | Optometry | NY | $132.9K | 1.0K | $130.52 |
| Kyle Hrymack | Optometry | NJ | $129.5K | 1.0K | $127.74 |
| Harryjohn Panaretos | Optometry | NJ | $127.4K | 948 | $134.37 |
Based on the data, CPT 92004 shows a 1.6x variation in pricing across states — moderate variation by Medicare standards.
Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.