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See a sample rate comparisonCPT 92240 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.
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.
| 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 | 26 - Professional component RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $245.50 national non-facility rate (2026) · View Medicare rates for 92240 |
| Medicaid Fee Schedule | $203.245 median of the 8 states in the free preview · View Medicaid rates for 92240 |
National average reimbursement for CPT 92240 by major payers:
$223.02
$265.99
$252.74
$332.78
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CPT 92240
5 of 25 sample ratesHigher to lower in this preview
Jenifer Lloyd
The Board Of Trustees Of The University Of Illinois
$380.60Published rateNora Ekeanya
Loyola University Medical Center
$266.52Published rateJoanna Garcia Pierce
Pediatric Faculty Foundation In
$147.85Published rateMohammed Alam
University Of Chicago
$84.54Published ratePatricia Wright
Town Center Orthopaedic Associates, P.C.
$42.91Published rate
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See a sample payer proposalCPT 92240 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92240 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 92240 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 |
|---|---|---|
| 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. |
| 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. |
| 92240-CPT | Moderate | 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. |
| 92242-CPT | Moderate | Fluorescein Angiography And In, Fluorescein Angiography And Indocyanine-Green Angiography (Includes Multiframe Imaging) Performed Atthe Same Patient Encounter With Interpretation An D 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 92240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92240 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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