CPT 92230 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 • 20 - Urgent Care Facility • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 92230 by major payers:
$112.91
$87.62
$104.40
$160.17
| 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 92230 | ||||||
United | 92230 | $136.88 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IA | Psychiatry Physician (2084P0800X) |
United | 92230 | $110.33 | 1841571841 - OMOTOLA AJIBADE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92230 | $141.88 | 1760419311 - PETER HEYDEMANN | 911780120 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92230 | $136.14 | 1093243149 - KRISTIN ROSSEAU | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 92230 | $125.59 | 1225211600 - JOHN MILLICHAP | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92230 | $155.16 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | FL | Psychiatry Physician (2084P0800X) |
United | 92230 | $155.16 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | AZ | Psychiatry Physician (2084P0800X) |
United | 92230 | $43.54 | 1144267865 - NITIN PATEL | 462706345 | MO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92230 | $98.41 | 1477181071 - KEVIN VARGHESE | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 92230 | $104.00 | 1003049966 - GIRISHKUMAR DHORAJIA | 850703768 - (IL) CARLE WEST PHYSICIAN GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 92230 | $151.72 | 1174859284 - MATTHEW NIEDZWIECKI | 910844563 | RI | Psychiatry Physician (2084P0800X) |
United | 92230 | $133.77 | 1841571841 - OMOTOLA AJIBADE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92230 | $22.90 | 1598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO | 832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC | FL | Home Health Agency (251E00000X) |
United | 92230 | $116.37 | 1063471159 - MARK WAINWRIGHT | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | WA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92230 | $133.77 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MT | Psychiatry Physician (2084P0800X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 92230 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92230 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 92230 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 |
|---|---|---|
| 92230-CPT | Low | Ophthalmoscpy;Fluorescein Angioscpy |
| 92235-CPT | Low | Fluorescein Angiography (Includes Multiframe Imaging) With Interpretation And Report Unilateral Or Bilateral. (Desc Revised 1/1/2017) |
| 92240-CPT | Moderate | Indocyanine-Green Angiography (Includes Multiframeimaging) With Interpretation And Report Unilateraunilateral Or Bilateral. (Desc Revised 1/1/2017) |
| 92242-CPT | Moderate | Fluorescein Angiography And Indocyanine-Green Angiography (Includes Multiframe Imaging) Performed At The Same Patient Encounter 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 92230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92230 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 92230) and we'll show you how you compare in 15 minutes or less.