CPT 92100 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 92100 by major payers:
$95.34
$99.70
$100.97
$133.68
| 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 92100 | ||||||
United | 92100 | $183.10 | 1225211600 - JOHN MILLICHAP | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92100 | $197.63 | 1811068554 - JAMES MACKENZIE | 205547757 - (IL) LURIE CHILDRENS MEDICAL GROUP LLC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92100 | $114.36 | 1225211600 - JOHN MILLICHAP | 841343242 | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92100 | $140.60 | 1528164829 - GUOSHI ZHANG | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $135.80 | 1235766916 - AMIRREZA FALLAHI | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $31.69 | 1922328426 - MAJED DALLOUL | 364340137 - (IL) SAINT ANTHONY HEALTH AFFILIATES | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $29.93 | 1689166027 - ANIRUDDHA DEKA | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $115.62 | 1932355591 - JONATHAN HOWARD | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $65.41 | 1245252303 - MARY FAHRMEIER | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $183.10 | 1780976399 - ANNA JEONG | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92100 | $90.01 | 1679515951 - EUGENE SCHNITZLER | 364035455 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92100 | $123.19 | 1427259670 - NADEEM HUSSAIN | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $578.50 | 1760502058 - P. DANIEL LE GRANGE | 943281673 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92100 | $225.63 | 1487817128 - QURAT UL AIN KHAN | 43466314 - MASS GENERAL BRIGHAM INCORPORATED | IL | Psychiatry Physician (2084P0800X) |
United | 92100 | $132.75 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | IL | 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 |
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CPT 92100 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92100 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 92100 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 |
|---|---|---|
| 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 |
| 92081-CPT | Low | Visual Field Examination, Unilateral Or Bilateral, With Interpretation And Report; Limited Examination (Eg, Tangent Screen, Autoplot, Arc Perimeter, Or Single Stimulus Level Automated Test, Such As Octopus 3 Or 7 Equivalent) |
| 92100-CPT | Low | Serial Tonometry (Separate Procedure) With Multiple Measurements Of Intraocular Pressure Over An Extended Time Period With Interpretation And Report, Same Day (Eg, Diurnal Curve Or Medical Treatment Of Acute Elevation Of Intraocular Pressure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92100 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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