CPT 92002 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Ophthalmology Services and Procedures |
| Common Place of Service | • 11 - Office • None • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 25 - Significant, separately identifiable E/M service same day • GC - Service performed by resident under supervision |
| Complexity Level | Low |
National average reimbursement for CPT 92002 by major payers:
$81.44
$95.95
$100.42
$115.69
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 92002 | ||||||
United | 92002 | $94.22 | 1154645786 - ONE STEP DIAGNOSTIC VII LP | 271803796 - (TX) ONE STEP DIAGNOSTIC VII LP | TX | Radiology Clinic/Center (261QR0200X) |
United | 92002 | $543.40 | 1609807122 - SPARTANBURG MEDICAL CENTER | 576000934 | SC | General Acute Care Hospital (282N00000X) |
United | 92002 | $210.92 | 1225450588 - PARISH HOSPITAL SERVICE DISTRICT FOR THE PARISH OF ORLEANS, NEW ORLEANS EAST HOSPITAL | 273335876 | LA | General Acute Care Hospital (282N00000X) |
United | 92002 | $49.15 | 1124111414 - QMG LLC DBA INSITE RADIOLOGY | 650730095 - (FL) QUALCARE MEDICAL GROUP, LLC | FL | Radiology Clinic/Center (261QR0200X) |
United | 92002 | $435.01 | 1194744805 - WEST PENN ALLEGHENY HEALTH SYSTEM INC, THE WESTERN PENNSYLVANIA HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 92002 | $254.36 | 1760020044 - THREE CROSSES REGIONAL HOSPITAL LLC | 852388743 - (NM) THREE CROSSES REGIONAL HOSPITAL LLC | NM | General Acute Care Hospital (282N00000X) |
United | 92002 | $456.67 | 1164400131 - LEHIGH VALLEY HOSPITAL, LEHIGH VALLEY HOSPITAL | 231689692 - LEHIGH VALLEY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 92002 | $41.66 | 1942630306 - VITAL IMAGING DIAGNOSTIC CENTERS LLC | 464012875 - (FL) VITAL IMAGING DIAGNOSTIC CENTERS | FL | Radiology Clinic/Center (261QR0200X) |
United | 92002 | $62.50 | 1255624847 - HOUSTON PREMIER RADIOLOGY CENTER INC. | 452136134 - (TX) HOUSTON PREMIER RADIOLOGY CENTER INC | TX | Radiology Clinic/Center (261QR0200X) |
United | 92002 | $250.02 | 1477640258 - ST. JOSEPH'S HOSPITAL, YONKERS | 131740127 - (NY) ST JOSEPHS HOSPITAL YONKERS | NY | General Acute Care Hospital (282N00000X) |
United | 92002 | $69.44 | 1730387911 - IMAGING ASSOCIATES OF ABILENE LLC | 260421465 - (TX) IMAGING ASSOCIATES OF ABILENE LLC DBA MEDICAL DIAGNOSTIC IMAGING | TX | Radiology Clinic/Center (261QR0200X) |
United | 92002 | $588.20 | 1659827756 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-GROVE | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92002 | $62.50 | 1124006721 - ULTRASOUND DIAGNOSTIC SERVICES, DIAGNOSTIC HEALTH SERVICES | 860291562 | AZ | Radiology Clinic/Center (261QR0200X) |
United | 92002 | $401.76 | 1073587119 - ST CLAIR MEMORIAL HOSPITAL, ST. CLAIR HOSPITAL | 251010303 - (PA) ST CLAIR HEALTH CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 92002 | $177.75 | 1669740056 - HIGHLANDS HOSPITAL AND HEALTH CENTER | 251494705 - HIGHLANDS HOSPITAL AND HEALTH CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 92002 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92002 code is part of the Medicine Services and Procedures services used for Ophthalmology Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 92002 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 92002-CPT | Low | Ophthalmological Services: Medical Examination And Evaluation With Initiation Of Diagnostic And Treatment Program; Intermediate, New Patient |
| 92004-CPT | Low | Ophthalmological Services: Medical Examination And Evaluation With Initiation Of Diagnostic And Treatment Program; Comprehensive, New Patient, 1 Or More Visits |
| 92012-CPT | Low | Ophthalmological Services: Medical Examination And Evaluation, With Initiation Or Continuation Of Diagnostic And Treatment Program; Intermediate, Established Patient |
| 92014-CPT | Low | Ophthalmological Services: Medical Examination And Evaluation, With Initiation Or Continuation Of Diagnostic And Treatment Program; Comprehensive, Established Patient, 1 Or More Visits |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92002. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92002 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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