HCPCS 92004

Other service (ClaimLight category; the code descriptor is not shown)

Other services Work RVU per service 1.82 (2020 fee schedule)

26,970
99th percentile among 6,116 codes billed · 2020
$156M
98th percentile among 6,116 codes billed · 2020
1.6M
97th percentile among 6,116 codes billed · 2020
37
68th percentile among 6,116 codes billed · 2020
184
68th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$100M$200M2020: $156M paid20202021: $185M paid20212022: $165M paid20222023: $159M paid20232024: $145M paid2024$145M$0$100M$200M2020: $156M paid20202021: $185M paid20212022: $165M paid20222023: $159M paid20232024: $145M paid2024$145M$0$100M$200M2020: $156M paid20202021: $185M paid20212022: $165M paid20222023: $159M paid20232024: $145M paid2024$145M$0$100M$200M2020: $156M paid20202021: $185M paid20212022: $165M paid20222023: $159M paid20232024: $145M paid2024$145M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

020K2020: 27K providers20202021: 29K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K020K2020: 27K providers20202021: 29K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K020K2020: 27K providers20202021: 29K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K020K2020: 27K providers20202021: 29K providers20212022: 27K providers20222023: 26K providers20232024: 26K providers202426K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
202425,728$145,004,470-9%1,523,496361751.82
202326,467$158,694,743-4% (2023 changed hospital and observation visit codes)1,645,023371881.82
202227,219$164,634,257-11%1,720,092381921.82
202128,819$185,242,984– (Not compared: 2021 changed office visit values)1,878,796401991.82
202026,970$155,657,962first year in data1,617,070371841.82

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
California1,946$14,698,994135,91441203
Florida1,836$14,103,415144,02447248
New York1,822$13,596,526118,66140191
Texas2,059$13,222,202139,76041213
Illinois967$5,820,99160,27838186
New Jersey845$5,606,15749,79434173
Pennsylvania1,039$4,671,68147,90930135
Virginia716$4,503,30046,91342205
Massachusetts886$4,398,31643,83036135
Arizona515$4,384,34646,49354264
Georgia698$4,127,57744,66539195
North Carolina742$3,537,61338,45132157
Ohio886$3,457,60840,12130132
Michigan733$3,357,42436,78332145
Tennessee632$3,351,91937,11935177

Not listed: 2 billers with an armed-forces or unknown state code (AA, AP); they are in the national totals.

Not listed: 3 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,951$15,552,622131,62041
Los Angeles-Long Beach-Anaheim, CA615$5,672,63149,23445
Chicago-Naperville-Elgin, IL-IN649$4,061,71540,87637
Miami-Fort Lauderdale-West Palm Beach, FL489$3,670,50935,33737
Dallas-Fort Worth-Arlington, TX505$3,523,70435,70738
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD528$2,865,37127,19432
Phoenix-Mesa-Chandler, AZ314$2,772,12828,89354
Boston-Cambridge-Newton, MA-NH602$2,757,09427,27432
Washington-Arlington-Alexandria, DC-VA-MD-WV400$2,661,29924,84238
Houston-Pasadena-The Woodlands, TX428$2,314,21823,77433
Atlanta-Sandy Springs-Roswell, GA356$1,886,05019,57933
Tampa-St. Petersburg-Clearwater, FL250$1,752,93518,30644
Baltimore-Columbia-Towson, MD274$1,695,76416,12940
Detroit-Warren-Dearborn, MI284$1,499,70315,78142
San Francisco-Oakland-Fremont, CA217$1,354,04911,92736

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 92004 nationally

Ophthalmology accounts for 57% of payment for 92004 nationally in 2020, across 3 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology10,58939%$89,272,03257%897,14685
Optometry16,35161%$66,241,24243%718,42144
Physician Assistant120.04%$36,2680.02%46739

Not listed: 9 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2020.

Top billers of 92004 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations