Instrument payback

How long an instrument takes to pay for itself, from numbers you already have. The rate field starts on the national average Medicare reimbursement for the code so you have somewhere to begin, but that figure is an average and not your contract. Type over it with your own if you have it, and the volume is your schedule either way.

The code shown is the one this service is commonly billed under. Which code applies, and when medical necessity is met, is between you and your payer.
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The quoted price plus installation and training. Ask me for the number if you do not have one yet.
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The greyed figure is the national average Medicare reimbursement for this code ($63.80), shown as a starting point. It is not your rate. What you actually collect varies by payer and by region: across the five states I cover, Medicare alone pays $59.42 to $64.68 for this code, and your commercial contracts will sit somewhere else again. Use your own fee schedule if you have it to hand.
Billable tests, not patients seen. Count what you would actually run and bill, not what the instrument could do.
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Consumables and staff time you would not otherwise spend: a tonometer probe, a technician’s minutes.
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Where the starting figure comes from

The greyed number in the rate field is the national Medicare amount for the code, worked out from the published relative values: the work, practice expense and malpractice units for the code, multiplied by the $33.4009 conversion factor. It is an average across the whole country and a floor for most practices, not a quote.

National average Medicare reimbursement, and what it becomes across North Dakota, South Dakota, Minnesota, Wisconsin and Iowa
CodeServiceNational average Across my five states
92083Threshold visual field (perimetry)$63.80$59.42 – $64.68
92134OCT, retina$32.73$30.48 – $32.89
92133OCT, optic nerve$30.73$28.62 – $30.84
92250Fundus photography$37.07$34.68 – $37.28
92132OCT, anterior segment$29.73$27.65 – $29.83

Source: CMS National Physician Fee Schedule Relative Value File, RVU26C (July 2026 release, published 2026-06-30). The state column applies each state’s geographic practice cost index to the same relative values, which is the same arithmetic Medicare does. Two things it still does not account for: your commercial payer mix, which is usually the larger effect, and what you actually collect after deductibles, denials and write-offs. Medicare also pays a different conversion factor to practices in a qualifying alternative payment model. Rates change at least annually.

What this does not tell you

Whether the volume is real. A perimeter that pays back in eleven months at eight fields a week pays back in three years at three, and the honest number is the one your schedule already shows. If you are close to the line, the instrument is usually not the thing to change first. See the comparisons for what the alternatives cost you in capability rather than dollars.

Talk it through with me

Tell me how your practice handles this now and what you want it to do, and we can work through the options together. You do not need to have settled on a product first.

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