#975 of 11K

92002

Intermediate eye exam, new patient

Intermediate eye exam, new patient is the #975 most-billed Medicaid procedure code, with $52.2M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $41.61.

Total Paid

$52.2M

0.00% of all spending

Total Claims

1.3M

Providers

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 92002? Based on 3K providers billing this code nationally.

Median

$41.61

Average

$45.72

Std Dev

$42.65

Max

$815.71

Percentile Distribution (Cost per Claim)

p10

$19.30

p25

$30.41

Median

$41.61

p75

$54.63

p90

$67.03

p95

$75.04

p99

$161.77

50% of providers bill between $30.41 and $54.63 per claim for this code.

90% bill between $19.30 and $67.03.

Top 1% bill above $161.77.

About This Procedure

HCPCS code 92002 (Intermediate eye exam, new patient) was billed by 3K providers across 1.3M claims, totaling $52.2M in Medicaid payments from 2018–2024. This code was used for 1.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$41.61

Providers Billing

National Spending

$52.2M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92002

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1245251222	$1.7M	$131.82	3.2× median	Top 10%
2	1659583383	$1.7M	$641.48	15.4× median	Top 1%
3	1326472945	$1.2M	$31.98	0.8× median	Below Median
4	1669470019	$754K	$54.92	1.3× median	Above 75th
5	1528022027	$622K	$48.45	1.2× median	Above Median
6	1285032433	$489K	$47.25	1.1× median	Above Median
7	1376639575	$405K	$45.55	1.1× median	Above Median
8	1790962637	$385K	$58.22	1.4× median	Above 75th
9	1144219379	$374K	$52.71	1.3× median	Above Median
10	1710945969	$370K	$168.07	4.0× median	Top 1%
11	Southern California Permanente Medical Group San Diego, CA · Health Maintenance Organization	$310K	$31.80	0.8× median	Below Median
12	1588617765	$307K	$52.74	1.3× median	Above Median
13	1679591887	$306K	$45.31	1.1× median	Above Median
14	Southern California Permanente Medical Group Bellflower, CA · Health Maintenance Organization	$305K	$31.31	0.8× median	Below Median
15	Permanente Medical Group Inc Stockton, CA · Anesthesiology	$294K	$18.27	0.4× median	Below Median
16	1538150743	$287K	$37.33	0.9× median	Below Median
17	1598846479	$280K	$34.82	0.8× median	Below Median
18	Southern California Permanente Medical Group Panorama City, CA · Health Maintenance Organization	$272K	$31.33	0.8× median	Below Median
19	1760736946	$270K	$42.19	1.0× median	Above Median
20	Southern California Permanente Medical Group Baldwin Park, CA · Health Maintenance Organization	$267K	$34.47	0.8× median	Below Median

Showing top 20 of 3K providers billing this code

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92004Ophthalmological exam, comprehensive, new patient$1.30B 92012Ophthalmological exam, intermediate, established patient$435.8M

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