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 | $1061.00 | 1508934217 - MARSHALL MEDICAL CENTER NORTH | 830375714 | AL | General Acute Care Hospital (282N00000X) |
United | 92018 | $6099.00 | 1942432471 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 92018 | $10648.45 | 1851847974 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-EASLEY | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92018 | $4866.37 | 1871137513 - CANYON ATLANTIC | 843385649 | TX | General Acute Care Hospital (282N00000X) |
United | 92018 | $121.63 | 1417968637 - LAKE JACKSON IMAGING CENTER | 900275776 - (TX) LAKE JACKSON IMAGING CENTER | TX | Radiology Clinic/Center (261QR0200X) |
United | 92018 | $4631.00 | 1407990088 - PMC HOSPITAL, LLC, ST. LUKE'S PATIENTS MEDICAL CENTER | 273280598 - (TX) PMC HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92018 | $8230.00 | 1619315785 - TORRANCE MEMORIAL HOSPITAL | 951644042 - (CA) TORRANCE MEMORIAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 92018 | $2829.00 | 1962024026 - CLHG-RUSTON LLC | 844422249 | LA | General Acute Care Hospital (282N00000X) |
United | 92018 | $108.12 | 1932152436 - E PLUS PET IMAGING XXI LP, PET IMAGING OF WILLOWBROOK | 202556631 - (TX) E PLUS PET IMAGING XXI LP | TX | Radiology Clinic/Center (261QR0200X) |
United | 92018 | $3724.00 | 1841264868 - UNIVERSITY HOSPITALS ST. JOHN MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER | 341260978 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | 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 | $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 | 92018 | $2647.00 | 1811971302 - MEDICAL UNIVERSITY OF OHIO AT TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER | 340967014 | OH | General Acute Care Hospital (282N00000X) |
United | 92018 | $4757.00 | 1538177589 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | General Acute Care Hospital (282N00000X) |
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 | 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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