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 | Ophthalmoscopy Procedures Special Ophthalmological 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 |
| Medicare Fee Schedule | View Medicare rates for 92202 |
National average reimbursement for CPT 92202 by major payers:
$19.64
$19.60
$19.29
$30.76
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
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 Special Ophthalmological Services and Procedures Codes
The CPT 92202 code is part of the Ophthalmoscopy Procedures services used for Special Ophthalmological 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 | Test To Analyze Cornea Shape, Test That Uses A Computer To Produce An Image And Analyze The Shape Of The Cornea (The Transparent Covering Of The Eye). |
| 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) |
| 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). |
| 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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