CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Ophthalmology
92014 — Ophthalmological services; established patient, comprehensive, with medical decision making of moderate or higher complexity
This is a complete eye exam for an established patient that includes a detailed evaluation of the full visual system and requires medical decision-making of at least moderate complexity.
- Typical setting: Eye doctor's office
- National avg charge (illustrative): $120–$280 (comprehensive established patient ophthalmology exam)
- Most-disputed reason: Billing 92014 for every established patient visit regardless of complexity — moderate-or-higher complexity medical decision-making must be documented to support the comprehensive exam code.
What it means
What 92014 actually means
This is a complete eye exam for an established patient that includes a detailed evaluation of the full visual system and requires medical decision-making of at least moderate complexity. It is the appropriate code for established patients with more complex eye conditions.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 92014 for every established patient visit regardless of complexity — moderate-or-higher complexity medical decision-making must be documented to support the comprehensive exam code.
- Adding separate charges for refraction (92015) alongside 92014 without informing the patient that refraction is typically NOT covered by medical insurance (it is an elective vision service).
- Coding 92014 when the visit was a brief medication check or uncomplicated IOP measurement that only supports an intermediate visit (92012).
If you see 92014 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 92014 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 92014 on a bill.
92014 FAQ
Plain-English answers.
What does 92014 usually cost?
$120–$280 (comprehensive established patient ophthalmology exam). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 92014?
Billing 92014 for every established patient visit regardless of complexity — moderate-or-higher complexity medical decision-making must be documented to support the comprehensive exam code.
What should I do if I see 92014 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 92014 before paying.
Don't pay 92014 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.