CPT 92014
Global XXX ActiveCompre oph exam est pt 1/>
CPT 92014 Billing & Documentation Guide
CPT code 92014 (Compre oph exam est pt 1/>) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.42, a non-facility practice expense RVU of 2.35, and a malpractice RVU of 0.04, a total non-facility RVU of 3.81 and facility RVU of 1.86. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $131.46, though rates vary from $115.54 to $166.55 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92014, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92014 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 92014 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92014
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.42 | 1.42 |
| Practice Expense RVU | 2.35 | 0.4 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 3.81 | 1.86 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92014
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $142.73 | $65.66 | $134.98 - $166.55 | 29 |
| Florida | $128.79 | $63.44 | $124.48 - $132.52 | 3 |
| Georgia | $123.98 | $61.85 | $119.04 - $128.92 | 2 |
| Illinois | $125.99 | $63.06 | $121.18 - $130.74 | 4 |
| Michigan | $123.02 | $61.86 | $120.6 - $125.43 | 2 |
| North Carolina | $121.52 | $60.75 | $121.52 - $121.52 | 1 |
| New York | $139.06 | $66.4 | $122.94 - $146.27 | 5 |
| Ohio | $120.44 | $60.97 | $120.44 - $120.44 | 1 |
| Pennsylvania | $126.17 | $62.38 | $120.75 - $131.59 | 2 |
| Texas | $126.21 | $62.08 | $120.1 - $131.75 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92014
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92014 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0115T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0116T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0469T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0548T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0567T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0568T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0569T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0570T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0571T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0572T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92014
What does CPT code 92014 mean? +
CPT code 92014 represents: Compre oph exam est pt 1/>. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92014? +
The 2026 Medicare national average non-facility payment for CPT 92014 is $131.46. Rates range from $115.54 to $166.55 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92014? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92014? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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