92012
Ophthalmological exam, intermediate, established patient
Ophthalmological exam, intermediate, established patient is the #312 most-billed Medicaid procedure code, with $435.8M in payments across 10.4M claims from 2018–2024. The national median cost per claim is $38.23.
Total Paid
$435.8M
0.04% of all spending
Total Claims
10.4M
Providers
8K
Avg Cost/Claim
$42
National Cost Distribution
How much do providers bill per claim for 92012? Based on 8K providers billing this code nationally.
Median
$38.23
Average
$40.36
Std Dev
$34.67
Max
$749.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $22.30 and $50.01 per claim for this code.
90% bill between $11.21 and $69.70.
Top 1% bill above $124.85.
About This Procedure
HCPCS code 92012 (Ophthalmological exam, intermediate, established patient) was billed by 8K providers across 10.4M claims, totaling $435.8M in Medicaid payments from 2018–2024. This code was used for 9.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$38.23
Providers Billing
8K
National Spending
$435.8M
Avg/Median Ratio
1.06×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 92012
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1245251222 | $9.4M |
| 2 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $5.4M |
| 3 | 1326472945 | $5.1M |
| 4 | Ahava Medical And Rehabilitation Center, Llc Brooklyn, NY · Rehabilitation Practitioner | $3.9M |
| 5 | 1659583383 | $3.6M |
| 6 | Phoenix Children's Hospital Phoenix, AZ · Pediatrics | $3.3M |
| 7 | 1740437763 | $3.3M |
| 8 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $2.9M |
| 9 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $2.9M |
| 10 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $2.8M |
| 11 | 1356860811 | $2.6M |
| 12 | 1588122691 | $2.5M |
| 13 | 1760541569 | $2.5M |
| 14 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $2.3M |
| 15 | 1730292541 | $2.1M |
| 16 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $2.1M |
| 17 | 1114931052 | $1.9M |
| 18 | 1528022027 | $1.8M |
| 19 | Premier Eye Care Of Florida Llc Coral Gables, FL · Exclusive Provider Organization | $1.8M |
| 20 | 1801874896 | $1.7M |
Showing top 20 of 8K providers billing this code