CPT 92015 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • GY - Notice of Liability Not Issued, Not Required Under Payer Policy. • GA - Required ABN issued and on file |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 92015 |
National average reimbursement for CPT 92015 by major payers:
$26.62
$32.57
$31.08
$37.84
| 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 92015 | ||||||
United | 92015 | $22.25 | 1194817213 - DAVID TERSCHLUSE | 770686817 - (FL) COMMUNITY HOSPITAL FAMILY PRACTICE LLC | FL | Surgery Physician (208600000X) |
United | 92015 | $18.65 | 1689611691 - PARAG GANDHI | 621799761 - (TN) WESLEY & KLIPPENSTEIN, P.C. | MD | Ophthalmology Physician (207W00000X) |
United | 92015 | $12.90 | 1053325563 - COREY BICKOFF | 461822378 - COREY IAN BICKOFF, MD, PC | NY | Ophthalmology Physician (207W00000X) |
United | 92015 | $48.36 | 1841678612 - REBECCA BAUSELL | 251918776 - (PA) DELAWARE VALLEY VISION ASSOCIATES GROUP PRACTICE LLC | MD | Ophthalmology Physician (207W00000X) |
United | 92015 | $25.79 | 1487909313 - RYAN SOBEL | 596012065 - NORTH BROWARD HOSPITAL DISTRICT | FL | Surgery Physician (208600000X) |
United | 92015 | $11.35 | 1558477448 - DAMON PETTINELLI | 132686866 - (NY) NEW YORK EYE SURGERY ASSOCIATES, PLLC | MD | Ophthalmology Physician (207W00000X) |
United | 92015 | $12.15 | 1104800143 - BRADLEY PHILLIPS | 743160748 - BRADLEY J PHILLIPS MD LLC | NY | Ophthalmology Physician (207W00000X) |
United | 92015 | $28.64 | 1154364263 - DARREN MITER | 590714812 - LEE MEMORIAL HEALTH SYSTEM | FL | Surgery Physician (208600000X) |
United | 92015 | $11.82 | 1104038231 - LESLIE GORDON | 146689219 | NY | Ophthalmology Physician (207W00000X) |
United | 92015 | $41.59 | 1548578594 - MATTHEW POMYKALA | 133843560 - CRYSTAL RUN HEALTHCARE PHYSICIANS, LLP | NY | Ophthalmology Physician (207W00000X) |
United | 92015 | $13.31 | 1124001151 - ZEEV STEGMAN | 114824146 | NY | Ophthalmology Physician (207W00000X) |
United | 92015 | $17.09 | 1619280534 - NIKALESH REDDY | 650720209 - (FL) DR. DOMINGO GALLIANO, JR., P.A. | FL | Surgery Physician (208600000X) |
United | 92015 | $34.72 | 1881654804 - ERIC SINGMAN | 526148737 - (MD) UNIVERSITY OF MARYLAND EYE ASSOCIATION PA | MD | Ophthalmology Physician (207W00000X) |
United | 92015 | $24.05 | 1801191184 - JONATHAN KRUH | 111631788 - JAMAICA HOSPITAL MEDICAL CENTER | NY | Ophthalmology Physician (207W00000X) |
United | 92015 | $37.75 | 1285078436 - JEREMY JOHN | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
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 92015 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92015 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 92015 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 |
| 92015-CPT | Low | Determination Of Refractive State |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92015 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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