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See a sample rate comparisonCPT 92065 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.
Orthoptic Andor Pleoptic Trai, Orthoptic Andor Pleoptic Training With Continuing Medical Direction And Evaluation Orthoptic Andor Pleoptic Training With Continuing Medical
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 11 - Office 49 - Independent Clinic |
| Common Modifiers | 76 - Repeat procedure by same physician KX - Requirements specified in the medical policy have been met |
| Complexity Level | Low |
| Medicare Fee Schedule | $38.41 national non-facility rate (2026) · View Medicare rates for 92065 |
| Medicaid Fee Schedule | $34.99 median of the 8 states in the free preview · View Medicaid rates for 92065 |
National average reimbursement for CPT 92065 by major payers:
$49.05
$59.59
$52.62
$70.74
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CPT 92065
5 of 25 sample ratesHigher to lower in this preview
Tanya Royster
Quincy Physicians & Surgeons Clinic S.C. D/B/A Quincy Medical Group
$139.10Published rateHossam Abdelsalam
The Board Of Trustees Of The University Of Illinois
$67.30Published rateAnita Pairitz
Loyola University Medical Center
$49.86Published rateElizabeth Homan
Advocate Health And Hospitals Corporation
$37.36Published rateKerry Cook
Town Center Orthopaedic Associates, P.C.
$16.26Published rate
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See a sample payer proposalCPT 92065 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92065 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 92065 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 |
|---|---|---|
| 92060-CPT | Low | Sensorimotor Examination, Sensorimotor Examination With Multiple Measurements Of Ocular Deviation (Eg Restrictive Or Paretic Muscle With Diplopia) With Interpretation And Report (Separate Procedure) |
| 92065-CPT | Low | Orthoptic Andor Pleoptic Trai, Orthoptic Andor Pleoptic Training With Continuing Medical Direction And Evaluation Orthoptic Andor Pleoptic Training With Continuing Medical |
| 92066-CPT | Low | Orthoptic Training Under Supervision Of Phys/Qhp, Orthoptic Training; Under Supervision Of A Physician Or Other Qualified Health Care Professional |
| 92071-CPT | Low | Fit Of Contct Lens For Treatmn Of Ocular Surfac Diseas, Fitting Of Contact Lens For Treatment Of Ocular Surface Disease |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92065 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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