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 | $14.61 | 1861446866 - MONICA HUNTER | 631185612 - (AL) SOUTHVIEW MEDICAL GROUP, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $30.15 | 1235136821 - THERESE LANGO | 272649285 | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $29.75 | 1164737490 - MOHAN EDUPUGANTI | 452867352 - INTEGRIS CARDIOVASCULAR PHYSICIANS LLC | MO | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $26.20 | 1285086504 - JOHN KOLAWOLE | 203204949 - THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFF OF UAB HLTH SYSTM | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $18.95 | 1851471122 - NASSER LAKKIS | 931371454 - (AL) USA HEALTH COMMUNITY PROVIDERS LLC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $17.18 | 1407810013 - LOVDIE LEWIS | 630837257 - (AL) CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $9.85 | 1881743607 - JOHN GALLA | 630889615 - (AL) CARDIOLOGY ASSOCIATES OF MOBILE, INC. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $19.48 | 1407810013 - LOVDIE LEWIS | 636000271 - (AL) THE DCH HEALTH CARE AUTHORITY | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $14.61 | 1477588408 - TIMOTHY LEE | 452803595 - (AL) ALABAMA HEART AND VASCULAR, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $16.72 | 1003932955 - JACOB TOWNSEND | 631119002 - (AL) BIRMINGHAM HEART CLINIC, PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $15.60 | 1861597916 - BRIAN COLE | 621763656 | TN | Interventional Cardiology Physician (207RI0011X) |
United | 92202 | $12.98 | 1750474516 - NORTHWEST TEXAS SURGICAL HOSPITAL, LLC, NORTHWEST TEXAS SURGERY CENTER | 233086987 - (TX) NORTHWEST TEXAS SURGICAL HOSPITAL LLC | TX | 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 | $17.19 | 1770573586 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 233069260 | TX | General Acute Care Hospital (282N00000X) |
United | 92202 | $29.60 | 1245278571 - PHILIP MUNSCHAUER | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
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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