CPT 92065 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 | • 11 - Office • 49 - Independent Clinic |
| Common Modifiers | • None • 76 - Repeat procedure by same physician • KX - Requirements specified in the medical policy have been met |
| Complexity Level | Low |
National average reimbursement for CPT 92065 by major payers:
$49.05
$59.59
$52.62
$71.71
| 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 92065 | ||||||
United | 92065 | $63.25 | 1225211600 - JOHN MILLICHAP | 460319070 - MONUMENT HEALTH RAPID CITY HOSPITAL INC | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92065 | $49.86 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | VA | Psychiatry Physician (2084P0800X) |
United | 92065 | $51.02 | 1578097846 - CHRISTOPHER LOMBARDI | 205566098 | IL | Psychiatry Physician (2084P0800X) |
United | 92065 | $31.45 | 1568921476 - YU ZHANG | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 92065 | $103.69 | 1962664789 - JAMIE EVANS | 910844563 | NC | Psychiatry Physician (2084P0800X) |
United | 92065 | $63.25 | 1225211600 - JOHN MILLICHAP | 460319070 - MONUMENT HEALTH RAPID CITY HOSPITAL INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92065 | $41.70 | 1790936540 - SRISHTI NANGIA | 131623978 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92065 | $32.72 | 1225211600 - JOHN MILLICHAP | 460319070 - MONUMENT HEALTH RAPID CITY HOSPITAL INC | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92065 | $68.19 | 1710206545 - NEIL JARIWALA | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 92065 | $90.13 | 1649610239 - MICHAEL BYRNE | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 92065 | $31.76 | 1710061486 - DAVID KEMP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92065 | $149.21 | 1265753867 - ASIFA CHOUDHRY | 850703768 - (IL) CARLE WEST PHYSICIAN GROUP INC | IN | Psychiatry Physician (2084P0800X) |
United | 92065 | $61.84 | 1669678009 - NADIA MIRZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92065 | $139.10 | 1851490791 - TANYA ROYSTER | 371206525 - QUINCY PHYSICIANS & SURGEONS CLINIC S.C. D/B/A QUINCY MEDICAL GROUP | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92065 | $89.73 | 1851376230 - ANITA PAIRITZ | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IN | Psychiatry Physician (2084P0800X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 With Multiple Measurements Of Ocular Deviation (Eg, Restrictive Or Paretic Muscle With Diplopia) With Interpretation And Report (Separate Procedure) |
| 92065-CPT | Low | Orthoptic Training; Performed By A Physician Or Other Qualified Health Care Professional (Desc Rvsd 1/1/23) |
| 92066-CPT | Low | Orthoptic Training; Under Supervision Of A Physician Or Other Qualified Health Care Professional |
| 92071-CPT | Low | 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 92065) and we'll show you how you compare in 15 minutes or less.