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 | $4594.00 | 1306126974 - TOMBALL TEXAS HOSPITAL COMPANY LLC, TOMBALL REGIONAL MEDICAL CENTER | 821349955 | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $2892.00 | 1619115383 - ASCENSION SETON, ASCENSION SETON HAYS | 741109643 - ASCENSION SETON | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $4367.00 | 1811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR | 621619857 | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $826.00 | 1750338620 - BIENVILLE MEDICAL CENTER, INC. | 743227578 | LA | Critical Access Hospital (282NC0060X) |
United | 92019 | $522.00 | 1013068808 - ST HELENA PARISH HOSPITAL, ST HELENA PARISH HOSPITAL | 720627145 - (LA) ST HELENA PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | 92019 | $6195.00 | 1396779948 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | 751047527 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $83.58 | 1124076401 - DECATUR HOSPITAL AUTHORITY, WISE HEALTH SYSTEM | 751250450 - (TX) DECATUR HOSPITAL AUTHORITY | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $4986.00 | 1134166192 - ORTHOPEDIC HOSPITAL LTD, TEXAS ORTHOPEDIC HOSPITAL | 760418502 - (TX) ORTHOPEDIC HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $134.33 | 1205874450 - THOMAS NOGUEIRA | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
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 | $5140.00 | 1124074273 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $3137.00 | 1710314141 - ST. LUKES HOSPITAL AT THE VINTAGE | 263734606 - (TX) ST LUKES HOSPITAL AT THE VINTAGE | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $3226.00 | 1730697350 - JACKSONVILLE HOSPITAL LLC, UTHEALTH EAST TEXAS JACKSONVILLE HOSPITAL | 824037220 | TX | General Acute Care Hospital (282N00000X) |
United | 92019 | $3844.00 | 1801299375 - OCHSNER MEDICAL CENTER, OCHSNER MEDICAL COMPLEX - RIVER PARISHES | 205432782 | LA | Critical Access Hospital (282NC0060X) |
United | 92019 | $3450.00 | 1467496802 - ST FRANCIS HOSPITAL, INC., ST. FRANCIS EASTSIDE | 582504530 - (SC) ST FRANCIS HOSPITAL INC | SC | 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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