CPT 92014: Comprehensive Eye Exam for Established Patient
Medicare pays $132 and commercial payers pay $187 on average nationally for this procedure.
CPT code 92014 describes a comprehensive ophthalmological eye examination for an established patient, typically including a detailed history, comprehensive examination of the anterior and posterior segments, and assessment of visual function; service type: comprehensive ophthalmology evaluation; typical site of service: office or outpatient ophthalmology clinic.
For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.
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National Reimbursement Benchmarks
National averages place Blue Cross Blue Shield and BUCA above Medicare: Blue Cross Blue Shield’s mean of $219.4 and BUCA’s mean of $186.7 compare with Medicare’s $132.1 average, indicating commercial payers generally reimburse higher for CPT 92014 than Medicare. The gap between BUCA and Medicare is $54.6, while the gap between Blue Cross Blue Shield and Medicare is $87.3, highlighting material differences between commercial-network averages and the Medicare baseline.
Examining dispersion using the interquartile spread (P75–P25) highlights variability across payers. Blue Cross Blue Shield shows the widest IQR at $90.6, followed by BUCA at $90.4 and UnitedHealth Group at $91.7 — together these reflect notable variability in commercial contracting. Aetna and Cigna are tighter, with IQRs of $73.0 and $97.3 respectively; Medicare’s IQR is narrow at $13, indicating the most consistent reimbursements among listed payers.