CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 92004 RVU and Medicare Payment (2026)
Compre oph exam new pt 1/> — 1.82 work RVU, about $149.64 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.82
- PE RVU (non-facility)
- 2.62
- PE RVU (facility)
- 0.47
- MP RVU
- 0.04
- Office payment
- $149.64
- Facility payment
- $77.82
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 92004 in a non-facility setting with national GPCI: (1.82 + 2.62 + 0.04) × $33.4009 ≈ $149.64. The same code in a facility setting pays about $77.82 because facility PE RVU (0.47) replaces office PE RVU.
What changes by locality
GPCI moves 92004 non-facility payment from $136.65 to $194.38 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 92004?
1.82. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 92004 in 2026?
About $149.64 non-facility ($77.82 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (1.82) and malpractice RVU stay fixed; only practice expense changes (2.62 office vs 0.47 facility). That is the entire office-vs-facility payment gap.