CPT 92018 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 50 - Bilateral Procedure |
| Complexity Level | Low |
National average reimbursement for CPT 92018 by major payers:
$169.57
$171.09
$175.48
$219.83
| 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 92018 | ||||||
United | 92018 | $3923.00 | 1679903967 - EBD BEMC BURLESON, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL BURLESON | 364755936 | TX | General Acute Care Hospital (282N00000X) |
United | 92018 | $154.17 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | 92018 | $9423.00 | 1023010113 - SOUTHERN CALIFORNIA HEALTHCARE SYSTEM, INC, SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD, AT VAN NUYS, AT CULVER CITY | 954690845 | CA | General Acute Care Hospital (282N00000X) |
United | 92018 | $2014.00 | 1730128836 - MIDWEST REGIONAL MEDICAL CENTER, LLC, ALLIANCEHEALTH MIDWEST | 730657693 - SSM HEALTH CARE OF OKLAHOMA INC | OK | General Acute Care Hospital (282N00000X) |
United | 92018 | $3246.00 | 1609804822 - BAPTIST HEALTH, BAPTIST HEALTH MEDICAL CENTER - HEBER SPRINGS | 710236856 - (AR) BAPTIST HEALTH | AR | Critical Access Hospital (282NC0060X) |
United | 92018 | $2148.00 | 1881056190 - MERIT HEALTH WESLEY | 522050792 | MS | General Acute Care Hospital (282N00000X) |
United | 92018 | $4055.57 | 1568848059 - CUMBERLAND SURGICAL HOSPITAL OF SAN ANTONIO LLC, LEGENT ORTHOPEDIC & SPINE | 474612520 | TX | General Acute Care Hospital (282N00000X) |
United | 92018 | $3817.00 | 1043279565 - ST. FRANCIS HOSPITAL | 112050523 - (NY) ST FRANCIS HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 92018 | $442.00 | 1063571107 - CHICOT MEMORIAL HOSPITAL | 383807713 - (AR) CHICOT MEMORIAL MEDICAL CENTER | AR | Critical Access Hospital (282NC0060X) |
United | 92018 | $3874.00 | 1770568123 - VHS ACQUISITION SUBSIDIARY NUMBER 3 INC, LOUIS A. WEISS MEMORIAL HOSPITAL | 352637418 | IL | General Acute Care Hospital (282N00000X) |
United | 92018 | $5599.00 | 1003236878 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL INC, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL SOMERSET | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 92018 | $2829.00 | 1962024026 - CLHG-RUSTON LLC | 844422249 | LA | General Acute Care Hospital (282N00000X) |
United | 92018 | $13923.00 | 1528079753 - BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST MARY'S HOSPITAL OF RICHMOND PRO FEE SERVICES | 540793767 - BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC | VA | General Acute Care Hospital (282N00000X) |
United | 92018 | $2747.00 | 1740400290 - AVISTA ADVENTIST HOSPITAL | 840438224 - PORTERCARE ADVENTIST HEALTH SYSTEM | CO | General Acute Care Hospital (282N00000X) |
United | 92018 | $5252.00 | 1003236878 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL INC, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL SOMERSET | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | 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 92018 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92018 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 92018 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 |
|---|---|---|
| 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 |
| 92018-CPT | Low | Ophthalmological Examination And Evaluation, Under General Anesthesia, With Or Without Manipulation Of Globe For Passive Range Of Motion Or Other Manipulation To Facilitate Diagnostic Examination; Complete |
| 92019-CPT | Low | Ophthalmological Examination And Evaluation, Under General Anesthesia, With Or Without Manipulation Of Globe For Passive Range Of Motion Or Other Manipulation To Facilitate Diagnostic Examination; Limited |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92018. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92018 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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