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See a sample rate comparisonCPT 92020 Fee Schedule
Last Verified: October 2026
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.
Eye Exam With Anesthesia, Exam Of The Front Of The Eye Using A Scope (Gonioscopy). The Test Is Performed With Anesthesia.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $26.72 national non-facility rate (2026) · View Medicare rates for 92020 |
| Medicaid Fee Schedule | $21.785 median of the 8 states in the free preview · View Medicaid rates for 92020 |
National average reimbursement for CPT 92020 by major payers:
$32.54
$33.08
$34.69
$33.93
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CPT 92020
5 of 25 sample ratesHigher to lower in this preview
Jacob Heng
Johns Hopkins University
$67.01Published rateSahand Bamarni
Baycare Medical Group Inc
$51.79Published rateJessica Groton
Lee Memorial Health System
$38.40Published rateNikalesh Reddy
Manatee Specialty Physician Alliance LLC
$25.55Published rateDamon Pettinelli
New York Eye Surgery Associates, PLLC
$16.60Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92020 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92020 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 92020 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 | Intrm Oph Exam New Patient, Ophthalmological Services Medical Examination And Evaluation With Initiation Of Diagnostic And Treatment Program Intermediate New Patient |
| 92014-CPT | Low | Compre Oph Exam Est Pt 1, Ophthalmological Services Medical Examination And Evaluation With Initiation Or Continuation Of Diagnostic And Treatment Program Comprehensive Established Patient 1 Or More Visits |
| 92015-CPT | Low | Determination Of Refractive State |
| 92020-CPT | Low | Eye Exam With Anesthesia, Exam Of The Front Of The Eye Using A Scope (Gonioscopy). The Test Is Performed With Anesthesia. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92020 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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