Cost analysis for CPT 92012 — Established patient problem focused exam of visual system
Average Medicare Payment
N/A
Total Payments (Latest)
N/A
Services (Latest)
N/A
Price Change (–)
N/A
The most expensive state pays 1.6x more than the cheapest for this procedure. NY averages $73.27 vs VI at $44.58.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $73.27 | $28.5M | 388.6K | 1.6K |
| CA | $72.41 | $38.2M | 527.3K | 1.6K |
| NJ | $71.78 | $14.7M | 205.4K | 798 |
| CT | $69.82 | $4.6M | 65.7K | 301 |
| MD | $69.24 | $5.1M | 74.2K | 358 |
| AK | $67.99 | $224.8K | 3.3K | 34 |
| GU | $67.62 | $41.7K | 616 | 6 |
| MA | $67.07 | $6.9M | 103.5K | 560 |
| DC | $66.61 | $192.9K | 2.9K | 28 |
| WA | $66.40 | $2.8M | 42.0K | 216 |
| HI | $65.11 | $1.9M | 29.5K | 147 |
| FL | $63.20 | $19.5M | 308.1K | 1.2K |
| VA | $62.93 | $5.1M | 81.0K | 429 |
| PA | $62.92 | $13.1M | 207.6K | 932 |
| DE | $62.62 | $920.6K | 14.7K | 43 |
| RI | $62.41 | $442.8K | 7.1K | 94 |
| AA | $61.78 | $7.2K | 117 | 1 |
| IL | $61.73 | $8.3M | 134.1K | 665 |
| MN | $61.55 | $1.8M | 29.2K | 204 |
| NV | $61.54 | $942.4K | 15.3K | 89 |
| NH | $60.86 | $548.4K | 9.0K | 67 |
| TX | $60.34 | $18.4M | 305.4K | 1.7K |
| CO | $60.33 | $1.5M | 24.2K | 213 |
| MT | $60.30 | $640.9K | 10.6K | 54 |
| AZ | $60.24 | $2.8M | 46.7K | 258 |
| MI | $59.95 | $3.1M | 52.2K | 457 |
| OR | $59.84 | $1.2M | 20.2K | 168 |
| WY | $58.85 | $98.6K | 1.7K | 16 |
| SD | $58.78 | $668.9K | 11.4K | 90 |
| GA | $58.50 | $4.0M | 68.1K | 379 |
| PR | $58.36 | $639.7K | 11.0K | 148 |
| SC | $58.04 | $3.3M | 57.6K | 236 |
| VT | $57.76 | $261.4K | 4.5K | 45 |
| OH | $57.64 | $2.7M | 46.1K | 332 |
| NC | $57.57 | $2.7M | 46.6K | 301 |
| MO | $56.95 | $2.9M | 50.4K | 326 |
| AL | $56.66 | $901.8K | 15.9K | 117 |
| LA | $56.25 | $4.1M | 72.3K | 348 |
| WI | $55.82 | $827.6K | 14.8K | 163 |
| NM | $55.64 | $724.5K | 13.0K | 77 |
| IN | $55.52 | $1.1M | 20.4K | 150 |
| ME | $55.39 | $681.9K | 12.3K | 131 |
| KS | $55.36 | $2.0M | 36.5K | 236 |
| NE | $55.31 | $760.8K | 13.8K | 98 |
| ID | $55.29 | $690.2K | 12.5K | 68 |
| TN | $55.02 | $2.4M | 44.0K | 387 |
| OK | $54.98 | $1.4M | 25.7K | 221 |
| MP | $54.91 | $44.3K | 806 | 4 |
| UT | $54.08 | $948.8K | 17.5K | 161 |
| AR | $53.39 | $2.1M | 38.5K | 221 |
| IA | $53.08 | $1.2M | 23.3K | 204 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Craig Fern | Ophthalmology | NY | $354.5K | 4.5K | $78.67 |
| Omesh Gupta | Ophthalmology | PA | $304.9K | 4.4K | $68.76 |
| David Westrich | Ophthalmology | MO | $289.5K | 5.0K | $57.79 |
| Gregory Harmon | Ophthalmology | NY | $283.0K | 3.8K | $73.85 |
| Paul Guerriero | Ophthalmology | NY | $273.4K | 3.9K | $69.54 |
| Carl Regillo | Ophthalmology | PA | $249.6K | 3.7K | $68.13 |
| Nikolas London | Ophthalmology | CA | $243.1K | 3.3K | $72.77 |
| Homayoun Tabandeh | Ophthalmology | CA | $235.7K | 2.9K | $80.10 |
| Robert Kleiner | Ophthalmology | PA | $234.5K | 3.2K | $73.77 |
| Mitchell Fineman | Ophthalmology | PA | $234.4K | 3.4K | $68.49 |
| Seung Choi | Optometry | NY | $232.4K | 2.9K | $80.35 |
| David Pinhas | Ophthalmology | NY | $226.0K | 2.8K | $81.66 |
| Arunan Sivalingam | Ophthalmology | PA | $224.5K | 3.3K | $68.47 |
| Scott Witherspoon | Ophthalmology | TX | $223.4K | 3.5K | $64.30 |
| Karl Waite | Ophthalmology | FL | $218.4K | 3.5K | $62.89 |
| Richard Kaiser | Ophthalmology | PA | $217.0K | 3.2K | $67.08 |
| Haroutun Hovanesian | Ophthalmology | CA | $213.5K | 2.9K | $74.38 |
| Allen Ho | Ophthalmology | PA | $212.9K | 3.0K | $70.65 |
| James Maisel | Ophthalmology | NY | $205.4K | 2.7K | $77.20 |
| Bradley Hamar | Optometry | CA | $202.6K | 3.0K | $68.02 |
Based on the data, CPT 92012 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.