CPT 92019 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 • 20 - Urgent Care Facility |
| Common Modifiers | • None • 59 - Distinct Procedural Service • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 92019 by major payers:
$88.22
$86.80
$84.14
$113.02
| 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 92019 | ||||||
United | 92019 | $5744.00 | 1841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $3836.00 | 1407364847 - TYLER REGIONAL HOSPITAL LLC | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $826.00 | 1235177320 - BIENVILLE MEDICAL CENTER, INC. | 743227578 | LA | Critical Access Hospital (282NC0060X) |
United | 92019 | $1975.00 | 1831193499 - HOSPITAL SERVICE DISTRICT NO 2 OF PARISH OF BEAUREGARD STATE OF LA, BEAUREGARD MEMORIAL HOSPITAL | 720491106 - WEST LOUISIANA HEALTH SERVICES INC | LA | Rural Acute Care Hospital (282NR1301X) |
United | 92019 | $63.50 | 1497275853 - ALEXANDER TRAN MD PA | 821967465 - (TX) ALEXANDER TRAN MD PA | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $80.80 | 1932729803 - DALLAS VAMC | 756108647 | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $4043.00 | 1972549855 - SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC, LAKE CHARLES MEMORIAL HOSPITAL | 720551963 - (LA) SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC | LA | General Acute Care Hospital (282N00000X) |
United | 92019 | $134.33 | 1053367276 - ELIZABETH WEAVER | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 92019 | $2429.00 | 1972071991 - GAINESVILLE COMMUNITY HOSPITAL, INC., NORTH TEXAS MEDICAL CENTER | 831683025 - (TX) GAINESVILLE COMMUNITY HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $2449.00 | 1750499273 - ASCENSION SETON, ASCENSION SETON SOUTHWEST | 741109643 - ASCENSION SETON | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $12091.00 | 1619924719 - COLUMBIA RIO GRANDE HEALTHCARE, L.P., RIO GRANDE REGIONAL HOSPITAL | 621656022 - (TX) COLUMBIA RIO GRANDE HEALTHCARE LP | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $5637.00 | 1659352987 - USMD HOSPITAL AT ARLINGTON, L.P. | 731662763 - (TX) USMD HOSPITAL AT ARLINGTON, LP | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $3693.00 | 1861087991 - CRESCENT CITY SURGICAL CENTRE OPERATING COMPANY, L.L.C. | 270508997 - (LA) CRESCENT CITY SURGICAL CENTRE | LA | General Acute Care Hospital (282N00000X) |
United | 92019 | $10262.00 | 1366496937 - TRIDENT MEDICAL CENTER LLC, TRIDENT MEDICAL CENTER | 621768106 | SC | General Acute Care Hospital (282N00000X) |
United | 92019 | $2995.00 | 1184911877 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE | 452663071 | TX | 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 92019 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92019 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 92019 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 |
| 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 |
| 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 92019. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92019 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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