Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 92265 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.
Needle Oculoelectromyography, Needle Oculoelectromyography One Or More Extraocularmuscles One Or Both Eyes With Interpretation And Report Needle Oculoelectromyography One Or More Extraocular
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $88.18 national non-facility rate (2026) · View Medicare rates for 92265 |
| Medicaid Fee Schedule | $71.61 median of the 8 states in the free preview · View Medicaid rates for 92265 |
National average reimbursement for CPT 92265 by major payers:
$104.70
$102.30
$98.03
$133.23
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 92265.
CPT 92265
5 of 25 sample ratesHigher to lower in this preview
John Millichap
$307.29Published rateJoseph Pepitone
Northshore University Healthsystem Faculty Practice Associates
$136.88Published rateDenis Altman
Pediatric Faculty Foundation In
$84.76Published rateBrad Berger
Presence Behavioral Health
$58.72Published rateKapil Aedma
Swope Health Services
$34.45Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 92265 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92265 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 92265 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 |
|---|---|---|
| 92260-CPT | Low | Measure Pressure In Eye Artery, Test To Measure Pressure In The Central Artery Located In The Retina (Layer Of Tissue In The Eye That Sends Sight Messages To The Brain). |
| 92265-CPT | Low | Needle Oculoelectromyography, Needle Oculoelectromyography One Or More Extraocularmuscles One Or Both Eyes With Interpretation And Report Needle Oculoelectromyography One Or More Extraocular |
| 92270-CPT | Low | Retina Eye (Light) Test, Test To Measure Responsiveness Of Retina (Layer Of Tissue In The Eye That Sends Sight Messages To The Brain) To Light And Other External Stimuli. Used To Detect Damage To The Retina. |
| 92273-CPT | Low | Retina Eye (Light) Test, Test To Measure Responsiveness Of Retina (Layer Of Tissue In The Eye That Sends Sight Messages To The Brain) To Light And Other External Stimuli. Used To Detect Damage To 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 92265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92265 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 92265) and we'll show you how you compare in 15 minutes or less.