CPT 92235 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 • 26 - Professional component • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 92235 by major payers:
$160.98
$137.79
$160.74
$217.00
| 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 92235 | ||||||
United | 92235 | $64.95 | 1023438009 - MOLLY MCINTOSH | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Home Health Agency (251E00000X) |
United | 92235 | $55.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 92235 | $86.51 | 1316561236 - CINDY CHANG | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | 92235 | $1014.86 | 1225289895 - PROVIDENCE HEALTH & SERVICES, PROVIDENCE HOLY FAMILY HOSPITAL | 352345508 | WA | General Acute Care Hospital (282N00000X) |
United | 92235 | $1026.70 | 1891740585 - BELLIN MEMORIAL HOSPITAL INC. | 390884478 - BELLIN MEMORIAL HOSPITAL INC | WI | General Acute Care Hospital (282N00000X) |
United | 92235 | $642.55 | 1114976263 - SLIDELL MEMORIAL HOSPITAL, MD IMAGING SLIDELL | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 92235 | $58.25 | 1669471710 - ASCENSION VIA CHRISTI IMAGING MANHATTAN, LLC | 481251984 - (KS) ASCENSION VIA CHRISTI IMAGING MANHATTAN LLC | KS | Radiology Clinic/Center (261QR0200X) |
United | 92235 | $68.47 | 1558391540 - MOBILE SONIX LLC | 200454278 - (FL) MOBILE SONIX LLC | FL | Radiology Clinic/Center (261QR0200X) |
United | 92235 | $162.11 | 1598971855 - OVERLAKE HOSPITAL MEDICAL CENTER LAB | 910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTER | WA | General Acute Care Hospital (282N00000X) |
United | 92235 | $156.88 | 1578898631 - UPMC WESTERN MARYLAND CORPORATION, WESTERN MARYLAND OUTPATIENT DIAGNOSTIC CENTER | 520591531 - UPMC WESTERN MARYLAND CORPORATION | MD | Radiology Clinic/Center (261QR0200X) |
United | 92235 | $44.27 | 1447376652 - NORTH HOUSTON X-RAY,INC, NORTH HOUSTON X-RAY & IMAGING CENTER | 760574907 - (TX) NORTH HOUSTON XRAYINC | TX | Radiology Clinic/Center (261QR0200X) |
United | 92235 | $377.16 | 1760714497 - SAVOY MEDICAL MANAGEMENT GROUP, INC., SAVOY PHYSICIAN SERVICES | 800202027 - (LA) SAVOY MEDICAL MANAGEMENT GROUP INC | LA | General Acute Care Hospital (282N00000X) |
United | 92235 | $1103.54 | 1548322720 - NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION, HAZLETON GENERAL HOSPITAL | 232421970 - (PA) NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 92235 | $31.37 | 1639308042 - IMAGING CENTER OF WEST PALM BEACH LLC, IMAGING CENTER OF LAKE WORTH WEST | 421581519 | FL | Radiology Clinic/Center (261QR0200X) |
United | 92235 | $97.81 | 1487692844 - TRIUMPH RADIOLOGY, INC. | 363995721 - (IL) TRIUMPH RADIOLOGY INC | IL | Radiology Clinic/Center (261QR0200X) |
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 92235 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92235 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 92235 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 | Remote Imaging For Detection Of Retinal Disease (Eg, Retinopathy In A Patient With Diabetes) With Analysis And Report Under Physician Supervision, Unilateral Or Bilateral |
| 92228-CPT | Low | Imaging Of Retina For Detection Or Monitoring Of Disease; With Remote Physician Or Other Qualified Health Care Professional Interpretation And Report Unilateral Or Bilateral (Desc Rvsd 1/1/21) |
| 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) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92235. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92235 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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