Average Medicaid Eye Exam Payments
Typical Medicaid Eye Exam reimbursement across 6,154 cities
Avg. Medicaid Paid
$34.29
Price Range
$0.00 – $514.26
Total Claims
132.9M
Cities
6154
Typical Payment Range
Typical Medicaid Eye Exam payments fall between $15.70 and $41.60 per claim (median: $27.93). The top 10% of payments exceed $57.73.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Comprehensive eye examinations assess vision and check for eye diseases. Includes refraction, eye health evaluation, and screening for conditions like glaucoma.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| New York, NY | $50.07 | $0.00 – $173.13 | 3,393,865 | 654 |
| Brooklyn, NY | $43.97 | $0.00 – $174.45 | 3,226,981 | 558 |
| Chicago, IL | $26.50 | $0.00 – $94.11 | 1,753,310 | 485 |
| Los Angeles, CA | $18.49 | $0.00 – $268.37 | 1,694,440 | 571 |
| Bronx, NY | $51.98 | $0.00 – $198.68 | 1,594,602 | 257 |
| San Diego, CA | $18.12 | $0.00 – $188.77 | 776,876 | 232 |
| Las Vegas, NV | $34.73 | $0.00 – $117.30 | 752,879 | 284 |
| Flushing, NY | $55.73 | $2.86 – $152.68 | 752,320 | 93 |
| Phoenix, AZ | $48.59 | $0.00 – $102.29 | 745,675 | 180 |
| Boston, MA | $41.15 | $0.53 – $122.57 | 701,137 | 306 |
| Fresno, CA | $6.34 | $0.00 – $249.25 | 654,893 | 139 |
| Rancho Cordova, CA | $0.38 | $0.00 – $17.74 | 647,061 | 14 |
| Philadelphia, PA | $31.97 | $0.00 – $118.29 | 566,378 | 322 |
| Indianapolis, IN | $43.23 | $0.00 – $74.51 | 556,124 | 160 |
| Colorado Springs, CO | $46.86 | $0.00 – $115.35 | 545,144 | 147 |
| Columbus, OH | $23.01 | $0.00 – $114.42 | 523,743 | 176 |
| San Jose, CA | $6.41 | $0.00 – $99.82 | 523,365 | 141 |
| Miami, FL | $32.64 | $0.00 – $137.83 | 513,703 | 197 |
| Albuquerque, NM | $50.34 | $0.00 – $109.69 | 495,549 | 123 |
| Glendale, CA | $12.92 | $0.00 – $111.89 | 495,326 | 84 |
| Sacramento, CA | $16.60 | $0.00 – $95.08 | 474,915 | 181 |
| Cleveland, OH | $30.89 | $0.00 – $98.60 | 474,632 | 132 |
| New Orleans, LA | $36.92 | $0.00 – $83.08 | 459,253 | 86 |
| Chula Vista, CA | $23.39 | $0.00 – $87.90 | 426,939 | 55 |
| Memphis, TN | $36.06 | $0.73 – $100.60 | 420,822 | 150 |
| Tucson, AZ | $49.14 | $0.00 – $129.56 | 408,354 | 115 |
| Long Beach, CA | $17.33 | $0.00 – $132.56 | 406,526 | 123 |
| Santa Ana, CA | $15.86 | $0.00 – $93.50 | 403,514 | 76 |
| San Francisco, CA | $15.17 | $0.00 – $147.86 | 396,535 | 200 |
| Houston, TX | $34.54 | $0.00 – $103.50 | 396,448 | 250 |
| Aurora, CO | $59.19 | $0.00 – $151.55 | 393,479 | 115 |
| Louisville, KY | $39.05 | $0.00 – $76.18 | 383,302 | 142 |
| Wichita, KS | $31.22 | $0.00 – $101.73 | 375,245 | 112 |
| Washington, DC | $40.12 | $0.00 – $92.61 | 372,949 | 103 |
| Baltimore, MD | $34.16 | $0.00 – $176.70 | 361,053 | 167 |
| Denver, CO | $36.17 | $0.00 – $113.84 | 352,392 | 118 |
| Detroit, MI | $33.38 | $0.00 – $124.53 | 350,035 | 40 |
| Lexington, KY | $34.61 | $3.21 – $70.47 | 341,411 | 102 |
| Nashville, TN | $34.20 | $0.00 – $206.47 | 338,061 | 117 |
| Portland, OR | $44.96 | $0.00 – $99.46 | 337,502 | 205 |
| Pasadena, CA | $22.37 | $0.00 – $82.88 | 329,869 | 91 |
| Montebello, CA | $18.04 | $0.00 – $40.13 | 329,321 | 30 |
| San Juan, PR | $38.11 | $0.00 – $253.77 | 328,091 | 112 |
| Tulsa, OK | $61.15 | $0.72 – $132.51 | 324,375 | 101 |
| Baton Rouge, LA | $39.75 | $0.00 – $82.80 | 315,944 | 68 |
| Honolulu, HI | $32.03 | $0.00 – $243.53 | 315,705 | 123 |
| Westminster, CA | $15.41 | $0.00 – $81.48 | 310,672 | 59 |
| Shreveport, LA | $39.71 | $0.00 – $70.02 | 308,372 | 45 |
| Waterbury, CT | $35.77 | $0.00 – $48.35 | 307,252 | 49 |
| Milwaukee, WI | $26.32 | $0.00 – $73.96 | 307,186 | 87 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 92015 | Refraction determination | $11.08 | 45,825,988 | 30,580 |
| 92014 | Eye exam estab pt comprehens | $53.49 | 34,678,723 | 31,373 |
| 92004 | Eye exam new patient compreh | $62.86 | 20,638,089 | 26,900 |
| 92012 | Eye exam estab pt intermedi | $41.74 | 10,441,311 | 12,861 |
| 92134 | Retinal OCT posterior segment | $17.76 | 9,310,449 | 6,690 |
| 92250 | Fundus photography | $28.59 | 7,948,707 | 10,428 |
| 92083 | Visual field exam extended | $31.87 | 3,202,240 | 4,820 |
| 92133 | Optic nerve imaging RNFL | $19.38 | 2,491,451 | 4,925 |
| 92002 | Eye exam new patient intermed | $39.06 | 1,337,321 | 3,576 |
| 92081 | Visual field exam limited | $8.73 | 1,037,034 | 1,303 |
| 92136 | Ophthalmic biometry | $20.12 | 671,455 | 1,857 |
| 92082 | Visual field exam intermed | $29.04 | 236,339 | 417 |
| 92132 | Anterior segment OCT | $15.77 | 89,204 | 192 |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.