CPT 92202 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 92202 by major payers:
$19.64
$19.60
$19.29
$33.53
| 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 92202 | ||||||
United | 92202 | $12.98 | 1740453000 - GRAHAM REGIONAL MEDICAL CENTER, GRAHAM GENERAL HSOPITAL PHYSICIANS | 751609992 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $15.05 | 1669480323 - KELL WEST REGIONAL HOSPITAL LLC | 752756307 - KELL WEST REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $15.59 | 1609135904 - ANDREW CORONA | 922417967 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $20.46 | 1275633604 - EL PASO VAMC | 742934770 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $27.71 | 1285651869 - JOHANNES BUITEWEG | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | MI | Diagnostic Radiology Physician (2085R0202X) |
United | 92202 | $19.01 | 1942682653 - RABIA JAMY | 752654757 - TEXAS NEUROLOGY, P. A. | TX | Neurology Physician (2084N0400X) |
United | 92202 | $22.17 | 1174572416 - DALLAS VAMC | 756108647 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $29.60 | 1326087669 - LINDA REILMAN | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 92202 | $22.17 | 1548588841 - HARLINGEN VAMC | 272466786 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $70.01 | 1104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | 92202 | $61.95 | 1649262791 - SABINE MEDICAL CENTER INC, SABINE MEDICAL CENTER | 262074318 | LA | General Acute Care Hospital (282N00000X) |
United | 92202 | $27.71 | 1861605602 - DAVID ISON | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | IL | Diagnostic Radiology Physician (2085R0202X) |
United | 92202 | $12.17 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $17.18 | 1407810013 - LOVDIE LEWIS | 630837257 - (AL) CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $122.70 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
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 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 |
|---|---|---|
| 92025-CPT | Low | Computerized Corneal Topography Unilateral Or Bilateral With Interpretation And Report |
| 92060-CPT | Low | Sensorimotor Examination With Multiple Measurements Of Ocular Deviation (Eg, Restrictive Or Paretic Muscle With Diplopia) With Interpretation And Report (Separate Procedure) |
| 92136-CPT | Low | Ophthalmic Biometry By Partial Coherence Interferometry With Intraocular Lens Power Calculation |
| 92202-CPT | Low | 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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