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See a sample rate comparisonCPT 92270 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.
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.
| 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 | 59 - Distinct Procedural Service 76 - Repeat procedure by same physician |
| Complexity Level | Low |
| Medicare Fee Schedule | $125.92 national non-facility rate (2026) · View Medicare rates for 92270 |
| Medicaid Fee Schedule | $104.57 median of the 8 states in the free preview · View Medicaid rates for 92270 |
National average reimbursement for CPT 92270 by major payers:
$128.01
$114.18
$117.35
$159.72
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CPT 92270
5 of 25 sample ratesHigher to lower in this preview
David Hsu
Aurora Medical Group Inc
$204.91Published rateSuraya Kawadry
Loyola University Medical Center
$138.19Published rateLuke Petry
The Board Of Trustees Of The University Of Illinois
$123.27Published rateMary Fahrmeier
$84.22Published rateArthur Traugott
Carle Health Care Incorporated
$38.06Published rate
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See a sample payer proposalCPT 92270 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92270 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 92270 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 |
|---|---|---|
| 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. |
| 92274-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 92270. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92270 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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