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See a sample rate comparisonCPT 92202 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.
Opscpy Extnd On Mac Draw, Ophthalmoscopy Extended With Drawing Of Optic Nerve Or Macula Eg For Glaucoma Macular Pathology Tumor With Interpretation And Report Unilateral Or Bilateral
| 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 RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $15.70 national non-facility rate (2026) · View Medicare rates for 92202 |
| Medicaid Fee Schedule | $12.785 median of the 8 states in the free preview · View Medicaid rates for 92202 |
National average reimbursement for CPT 92202 by major payers:
$19.64
$19.60
$19.29
$30.76
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CPT 92202
5 of 25 sample ratesHigher to lower in this preview
St. Tammany Parish Hospital Service District No 1, St. Tammany Parish Hospital
$159.66Published ratePhilip Munschauer
Professional Radiology, Inc.
$29.60Published rateDallas Vamc
$22.17Published rateLovdie Lewis
Cardiology Consultants, P.C.
$17.18Published rateEastland Memorial Hospital District, Eastland Memorial Hospital
$12.17Published rate
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See a sample payer proposalCPT 92202 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92202 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 92202 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 |
|---|---|---|
| 92136-CPT | Low | Measure For Eye Lens Implant, Eye Measurements Are Taken To Create A Personalized Lens Implant; Used To Treat Cataracts (A Clouding Of The Lens In The Eye). |
| 92145-CPT | Low | Corneal Hysteresis Determinati, Corneal Hysteresis Determination By Air Impulse Stimulation Unilateral Or Bilateral With Interpretation And Report |
| 92201-CPT | Low | Opscpy Extnd Rta Draw Uni Bi, Ophthalmoscopy Extended With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease Eg For Retinal Tear Retinal Detachment Retinal Tumor With Interpretation And Report Unilateral Or Bilateral |
| 92202-CPT | Low | Opscpy Extnd On Mac Draw, Ophthalmoscopy Extended With Drawing Of Optic Nerve Or Macula Eg For Glaucoma Macular Pathology Tumor With Interpretation And Report Unilateral Or Bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92202 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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