CPT 92353 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Ophthalmology Services and Procedures |
| Common Place of Service | • 11 - Office • None |
| Common Modifiers | • None • RA • GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Low |
National average reimbursement for CPT 92353 by major payers:

$58.57

$58.80

$57.21

$77.64
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 92353 | ||||||
United | 92353 | $18.95 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 92353 | $61.59 | 1174859284 - MATTHEW NIEDZWIECKI | 811324691 | IL | Psychiatry Physician (2084P0800X) |
United | 92353 | $77.12 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | VA | Psychiatry Physician (2084P0800X) |
United | 92353 | $125.54 | 1568752665 - ANDREW KNOX | 391678306 - AURORA MEDICAL GROUP INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92353 | $113.76 | 1891921367 - KAVITA THAKKAR | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92353 | $61.59 | 1174859284 - MATTHEW NIEDZWIECKI | 811324691 | IL | Psychiatry Physician (2084P0800X) |
United | 92353 | $93.48 | 1669524369 - JENNIFER KURTH | 205734385 | IL | Psychiatry Physician (2084P0800X) |
United | 92353 | $93.48 | 1750451472 - POONAM JHA | 205734385 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92353 | $27.51 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92353 | $60.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 92353 | $113.76 | 1629335260 - DIVYA DESAI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92353 | $73.29 | 1639227374 - VIKRAMJIT GILL | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | IL | Psychiatry Physician (2084P0800X) |
United | 92353 | $88.00 | 1083681654 - DAVID SCHILLING | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92353 | $91.79 | 1982268959 - SIDRAH NAJAM | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IN | Psychiatry Physician (2084P0800X) |
United | 92353 | $88.55 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | MN | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 92353 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92353 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 92353 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92353. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92353 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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