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See a sample rate comparisonHealthcare 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 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $39.41 national non-facility rate (2026) · View Medicare rates for 92286 |
| Medicaid Fee Schedule | $34.215 median of the 8 states in the free preview · View Medicaid rates for 92286 |
National average reimbursement for CPT 92286 by major payers:

$59.79

$78.39

$78.10

$87.09
Choose a payer to see a sample of rates for CPT 92286.
Suzanne Gozdanovic
Tampa Bay Surgical Group, LLP
Isaac Motamarry
North Florida Surgeons, P.A.
Travis Frazier
Cascade Eye And Skin Centers, P.C.
Nizar Makan
Cascade Eye And Skin Centers, P.C.
Kyron Tamar
Ims Medical Solutions LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
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Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 92286 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92286 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 92286 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 |
|---|---|---|
| 92283-CPT | Low | Color Vision Examination Exte, Color Vision Examination Extended Eg Anomaloscope Orequivalent Color Vision Examination Extended Eg Anomaloscope Or |
| 92284-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. |
| 92286-CPT | Low | Special Anterior Segment Photo, Special Anterior Segment Photography With Interpretation Andreport With Specular Endothelial Microscopy And Cell Count Special Anterior Segment Photography With Interpretation And |
| 92287-CPT | Low | Special Anterior Segment Photo, Special Anterior Segment Photography With Interpretation Andreport With Fluorescein Angiography Special Anterior Segment Photography With Interpretation And |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92286. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92286 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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