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See a sample rate comparisonCPT 92273 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 99 - Other POS |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $123.25 national non-facility rate (2026) · View Medicare rates for 92273 |
| Medicaid Fee Schedule | $99.645 median of the 8 states in the free preview · View Medicaid rates for 92273 |
National average reimbursement for CPT 92273 by major payers:
$169.39
$162.16
$155.65
$210.16
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CPT 92273
5 of 25 sample ratesHigher to lower in this preview
Pejman Bakhtiary
The Regents Of The University Of California
$706.40Published rateDavid Moline
Tracy Optometry Group, Inc.
$168.19Published rateCarleton Fong
Eye Care West Optometry Oc Inc
$121.33Published rateElizabeth Camara
$103.13Published rateZakaria Almuwaqqat
Emory University
$69.87Published rate
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See a sample payer proposalCPT 92273 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92273 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 92273 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 92273. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92273 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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