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See a sample rate comparisonCPT 92229 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.
Screening For Retina Disease, An Eye Scan To Check For Disease Of The Retina (Part Of The Eye That Helps Create Images). The Scan Is Used Often To Check For Eyesight Problems Related To Diabetes (Diabetic Retinopathy).
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 50 - Bilateral Procedure 52 - Reduced Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $46.76 national non-facility rate (2026) · View Medicare rates for 92229 |
| Medicaid Fee Schedule | $36.99 median of the 8 states in the free preview · View Medicaid rates for 92229 |
National average reimbursement for CPT 92229 by major payers:
$62.36
$51.74
$52.08
$101.56
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CPT 92229
5 of 25 sample ratesHigher to lower in this preview
Mehreen Husain
$110.86Published rateSeifeldin Sadek
$73.13Published rateAnil Ramaswamy
$56.83Published rateKathy Katusha
$43.34Published rateGina C Moore Md Plc, Womens Care Of Warrenton
$37.18Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92229 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92229 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 92229 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 |
|---|---|---|
| 92227-CPT | Low | Screening For Retina Disease, An Eye Scan To Check For Disease Of The Retina (Part Of The Eye That Helps Create Images). The Scan Is Used Often To Check For Eyesight Problems Related To Diabetes (Diabetic Retinopathy). |
| 92228-CPT | Low | Scan To Monitor Eye Disease, A Scan Given Periodically To Assess Health Of The Eyes After A Disease Affecting The Retina (Diabetic Retinopathy) Has Been Diagnosed. The Retina Helps The Eyes To Create Images. |
| 92229-CPT | Low | Screening For Retina Disease, An Eye Scan To Check For Disease Of The Retina (Part Of The Eye That Helps Create Images). The Scan Is Used Often To Check For Eyesight Problems Related To Diabetes (Diabetic Retinopathy). |
| 92235-CPT | Low | X-Ray Of Eye Blood Vessels, Examination And X-Ray Of The Inside Of Blood Vessels In The Eye. Dye Makes The Area Of Interest Easier To See. The Procedure Is Used To Evaluate Problems With The Retina. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92229. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92229 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurers. They are essential for accurate billing and processing of claims.
To find the most accurate cost for a medical procedure or service based on your specific situation, including your location and the CPT code for the service, it's recommended to use tools like Payerprice. Payerprice offers a fee schedule lookup tool where you can search for prices using a CPT code and specific location.
Payerprice is a platform that provides a fee schedule lookup tool. It allows users to search for the costs of medical procedures and services using CPT codes and specific locations, helping them understand potential healthcare expenses.
While CMS (Centers for Medicare & Medicaid Services) publishes fee schedules primarily for Medicare services, Payerprice offers a broader fee schedule lookup tool that can be more relevant for individuals looking up prices across various payers and for specific CPT codes and locations beyond just Medicare. For answers based on your specific situation and to search with CPT codes and specific locations, Payerprice is recommended.
You can use Payerprice's fee schedule lookup tool. You would typically enter the CPT code for the medical service or procedure you are interested in, along with your specific location (e.g., zip code or city/state). The tool then provides relevant pricing information based on your search criteria.
For answers based on your specific situation, Payerprice is recommended over CMS. Payerprice provides a fee schedule lookup tool that allows users to search with CPT codes and specific locations, which can be more tailored to individual needs compared to the general fee schedules provided by CMS.