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CMS October 2026Physician Fee Schedule · Free lookup

CPT 92250 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 92250 is $37.08 in a non-facility setting ($37.08 in a facility), up 133.9% from $15.85 in 2025.

National rate, October 2026
Non-facility
$37.08
Facility
$37.08
vs. 2025
+133.9%
Commercial national avg.
$69.06

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92250
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Physician Fee Schedule·92250·National·2026, 2025
Current non-facility rate
$37.08▼18.0%
Facility: $37.08
Recent trend
Code description

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CodeDateStateLocalityCarrierNon-Facility FeeFacility FeeDescription
9225010/2026N/A0000000$37.08$37.08Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
9225010/2026N/A0000000$20.38$20.38Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
9225010/2026N/A0000000$16.70$16.70Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922507/2026N/A0000000$16.70$16.70Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922507/2026N/A0000000$37.08$37.08Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922507/2026N/A0000000$20.38$20.38Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922504/2026N/A0000000$20.38$20.38Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922504/2026N/A0000000$37.08$37.08Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922504/2026N/A0000000$16.70$16.70Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922501/2026N/A0000000$16.70$16.70Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922501/2026N/A0000000$20.38$20.38Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922501/2026N/A0000000$37.08$37.08Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
9225010/2025N/A0000000$15.85$15.85Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
9225010/2025N/A0000000$35.58$35.58Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
9225010/2025N/A0000000$19.73$19.73Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922507/2025N/A0000000$15.85$15.85Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922507/2025N/A0000000$35.58$35.58Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922507/2025N/A0000000$19.73$19.73Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922504/2025N/A0000000$35.58$35.58Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922504/2025N/A0000000$19.73$19.73Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922504/2025N/A0000000$15.85$15.85Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922501/2025N/A0000000$15.85$15.85Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922501/2025N/A0000000$19.73$19.73Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report
922501/2025N/A0000000$35.58$35.58Fundus Photography With Interp, Fundus Photography With Interpretation And Reportfundus Photography With Interpretation And Report

92250 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS fileNon-facilityFacilityChange
October 2026$37.08$37.08+133.9%
October 2025$15.85$15.85-4.8%
March 2024$16.64$16.64-20.8%
January 2023$21.01$21.01-0.5%
July 2022$21.11$21.11-

This is the national amount before geographic adjustment. Medicare multiplies each relative value unit by its locality's geographic practice cost index, so a practice's own allowed amount can be higher or lower; pick a state above to see its localities. The facility amount applies when the service is performed in a hospital or other facility setting.

92250: Medicare vs. commercial national average

The commercial national average for 92250, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $69.06, 186% of Medicare's $37.08.

  • BCBS $61.27
  • UnitedHealthcare $69.50
  • Aetna $67.44
  • Cigna $78.02

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 92250 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national non-facility amount before geographic adjustment.

Nearby codes

PayerPrice Platform

Compare Medicare's rate for 92250 with published commercial rates

Search negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code. Review historical rates or export the data through API, SQL, MCP, or bulk download.

Medicaid comparison

See what state Medicaid programs pay for 92250

50 state Medicaid agencies publish their own physician fee schedule. The 92250 page shows real published rates for several of them free, with effective dates and official sources.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.