HCPCS 92250

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

Other services Work RVU per service 0.40 (2021 fee schedule)

24,669
99th percentile among 6,253 codes billed · 2021
$92M
97th percentile among 6,253 codes billed · 2021
3.3M
98th percentile among 6,253 codes billed · 2021
60
79th percentile among 6,253 codes billed · 2021
494
81st percentile among 6,253 codes billed · 2021
-1.3%
Medicare payment on the code vs 2020; billers +6.0% · 2021

Trend

Medicare payment on the code

$0$50M$100M2020: $93M paid20202021: $92M paid20212022: $84M paid20222023: $86M paid20232024: $87M paid2024$87M$0$50M$100M2020: $93M paid20202021: $92M paid20212022: $84M paid20222023: $86M paid20232024: $87M paid2024$87M$0$50M$100M2020: $93M paid20202021: $92M paid20212022: $84M paid20222023: $86M paid20232024: $87M paid2024$87M$0$50M$100M2020: $93M paid20202021: $92M paid20212022: $84M paid20222023: $86M paid20232024: $87M paid2024$87M

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

Billers

010K20K2020: 23K providers20202021: 25K providers20212022: 25K providers20222023: 25K providers20232024: 25K providers202425K010K20K2020: 23K providers20202021: 25K providers20212022: 25K providers20222023: 25K providers20232024: 25K providers202425K010K20K2020: 23K providers20202021: 25K providers20212022: 25K providers20222023: 25K providers20232024: 25K providers202425K010K20K2020: 23K providers20202021: 25K providers20212022: 25K providers20222023: 25K providers20232024: 25K providers202425K

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
202425,483$86,790,642+1%3,413,264634900.40
202325,087$86,318,933+3%3,326,330624910.40
202224,648$83,564,666-9%3,223,259614860.40
202124,669$92,060,263-1%3,286,065604940.40
202023,277$93,301,518first year in data2,914,033584580.40

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
California2,143$10,833,928348,25962689
New York1,680$9,059,438281,48577624
Florida1,426$8,487,620298,66284777
Texas1,823$5,968,713218,64851430
New Jersey906$4,887,423151,15181638
Pennsylvania1,194$3,805,213138,02254461
North Carolina896$3,345,924130,09575511
Illinois913$3,141,343115,30168447
Virginia643$2,874,678102,84271592
Maryland443$2,579,99882,52266738
Michigan757$2,299,56685,56453438
Massachusetts554$2,002,40867,26856414
Washington616$1,998,67072,07051493
Ohio749$1,855,81372,68145365
Georgia614$1,788,86967,79651407

Not listed: 4 billers with an armed-forces or unknown state code (AE, AP, ZZ); 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,952$11,457,127345,35082
Los Angeles-Long Beach-Anaheim, CA709$4,196,254132,40369
Washington-Arlington-Alexandria, DC-VA-MD-WV410$2,496,00778,62183
Miami-Fort Lauderdale-West Palm Beach, FL416$2,218,38876,42287
Chicago-Naperville-Elgin, IL-IN621$2,175,09776,40761
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD573$2,159,82871,96858
Dallas-Fort Worth-Arlington, TX532$1,677,14760,20849
Boston-Cambridge-Newton, MA-NH407$1,471,60748,92354
Detroit-Warren-Dearborn, MI356$1,441,52351,96262
San Francisco-Oakland-Fremont, CA260$1,182,30334,22448
Tampa-St. Petersburg-Clearwater, FL187$1,067,75838,203100
Houston-Pasadena-The Woodlands, TX387$1,050,62936,93148
Phoenix-Mesa-Chandler, AZ318$1,032,41239,33854
Cape Coral-Fort Myers, FL87$1,022,79034,10698
Seattle-Tacoma-Bellevue, WA263$900,85530,65345

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 2021.

Specialties billing 92250 nationally

Ophthalmology accounts for 56% of payment for 92250 nationally in 2021, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology8,47134%$51,876,42556%1,772,093209
Optometry15,45363%$39,590,81143%1,489,00196
Family Practice3271.3%$186,7180.20%7,87324
Internal Medicine2250.91%$151,8960.16%6,08227
Neurology350.14%$73,9050.08%2,59474
Physician Assistant370.15%$63,6080.07%3,64498
Endocrinology490.20%$44,7510.05%1,62033
Nurse Practitioner410.17%$40,7590.04%1,91947

Not listed: 16 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 2021.

Top billers of 92250 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