New patient problem focused exam of visual system
Medicare pricing data for 15,347 providers across 52 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
New patient problem focused exam of visual system (HCPCS code 92002) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $84.85, but hospitals typically charge $158.57 — a 1.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $84.85, your out-of-pocket cost would be approximately $16.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $56.26 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $100 | $208 | 35 | 411 | +17.3% |
| California | $94 | $170 | 1,378 | 12,434 | +10.9% |
| New Jersey | $94 | $192 | 568 | 5,580 | +10.3% |
| New York | $93 | $194 | 1,302 | 17,810 | +9.7% |
| Maryland | $91 | $150 | 312 | 3,629 | +7.5% |
| District of Columbia | $91 | $202 | 19 | 99 | +7.1% |
| Connecticut | $89 | $177 | 257 | 2,910 | +4.9% |
| Hawaii | $87 | $148 | 82 | 376 | +2.8% |
| Massachusetts | $87 | $188 | 491 | 3,932 | +2.7% |
| New Hampshire | $87 | $164 | 59 | 328 | +2.6% |
| Washington | $86 | $141 | 198 | 1,448 | +1.5% |
| Montana | $85 | $116 | 49 | 257 | +0.6% |
| Virginia | $85 | $141 | 380 | 2,926 | +0.5% |
| Wyoming | $85 | $114 | 13 | 39 | -0.0% |
| Delaware | $85 | $112 | 36 | 1,204 | -0.3% |
| Nevada | $85 | $166 | 85 | 582 | -0.3% |
| Florida | $83 | $158 | 937 | 9,624 | -2.1% |
| Oregon | $83 | $167 | 160 | 834 | -2.5% |
| Texas | $82 | $142 | 1,559 | 12,769 | -3.2% |
| Vermont | $82 | $161 | 52 | 397 | -3.4% |
| Pennsylvania | $82 | $141 | 799 | 6,034 | -3.7% |
| Puerto Rico | $82 | $85 | 137 | 685 | -3.9% |
| Rhode Island | $81 | $175 | 68 | 311 | -4.2% |
| South Dakota | $81 | $120 | 99 | 584 | -4.3% |
| Minnesota | $81 | $218 | 245 | 1,241 | -4.4% |
| Arizona | $81 | $155 | 255 | 2,051 | -4.5% |
| Michigan | $80 | $121 | 421 | 1,977 | -5.2% |
| Illinois | $79 | $147 | 594 | 5,812 | -6.3% |
| Idaho | $79 | $156 | 54 | 481 | -6.5% |
| Georgia | $79 | $195 | 335 | 2,293 | -6.7% |
| Kansas | $79 | $139 | 221 | 1,959 | -6.7% |
| South Carolina | $79 | $152 | 233 | 1,812 | -6.7% |
| Nebraska | $79 | $143 | 117 | 786 | -6.8% |
| North Dakota | $79 | $140 | 74 | 466 | -7.2% |
| New Mexico | $79 | $125 | 84 | 799 | -7.2% |
| Tennessee | $78 | $124 | 372 | 2,580 | -7.6% |
| Wisconsin | $78 | $215 | 199 | 898 | -7.8% |
| Missouri | $78 | $126 | 299 | 1,815 | -8.0% |
| Colorado | $78 | $180 | 240 | 1,088 | -8.1% |
| Maine | $78 | $129 | 110 | 401 | -8.2% |
| Indiana | $77 | $104 | 163 | 1,328 | -8.9% |
| Oklahoma | $77 | $137 | 211 | 1,521 | -9.1% |
| Alabama | $77 | $135 | 140 | 715 | -9.2% |
| Iowa | $77 | $158 | 212 | 1,204 | -9.3% |
| North Carolina | $77 | $120 | 278 | 1,693 | -9.4% |
| West Virginia | $77 | $107 | 68 | 561 | -9.8% |
| Mississippi | $76 | $119 | 217 | 1,760 | -10.4% |
| Louisiana | $76 | $139 | 310 | 1,978 | -10.4% |
| Kentucky | $76 | $106 | 106 | 711 | -10.9% |
| Ohio | $75 | $154 | 340 | 1,485 | -11.8% |
| Arkansas | $75 | $135 | 194 | 1,786 | -12.1% |
| Utah | $73 | $145 | 140 | 894 | -14.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber