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 92354 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.
Fit Of Spectacl Mounted Low Vision Aid; Sngle Element System, Fitting Of Spectacle Mounted Low Vision Aid; Single Element System
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 92354 |
| Medicaid Fee Schedule | $14.325 median of the 8 states in the free preview · View Medicaid rates for 92354 |
National average reimbursement for CPT 92354 by major payers:
$44.22
$72.85
$32.01
$72.67
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 92354.
CPT 92354
5 of 25 sample ratesHigher to lower in this preview
Andrew Knox
Rockford Health Physicians
$539.39Published rateTrilok Shah
Ascension Medical Group-Fox Valley Wisconsin Inc
$42.97Published rateStacey Occomy
Advocate Health And Hospitals Corporation
$24.13Published rateBetsy Ostrander
Scl Health Montana
$22.61Published rateClint Anthony
District Medical Group Inc
$10.72Published 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 92354 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92354 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 92354 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 |
|---|---|---|
| 92353-CPT | Low | Fitting For Eyeglasses, Fitting Of An Eyeglass Worn To Correct A Condition Where The Natural Lens Of A Persons Eye Is Missing (Aphakia). |
| 92354-CPT | Low | Fit Of Spectacl Mounted Low Vision Aid; Sngle Element System, Fitting Of Spectacle Mounted Low Vision Aid; Single Element System |
| 92355-CPT | Low | Fit Of Spectacl Mounted Low Vision Aid; Telscopic Or Other Comp, Fitting Of Spectacle Mounted Low Vision Aid; Telescopic Or Other Compo |
| 92358-CPT | Low | Prosthes Svc For Aphakia Temp (Disposable Or Loan Includ, Prosthesis Service For Aphakia Temporary (Disposable Or Loan Includi |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92354. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92354 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 92354) and we'll show you how you compare in 15 minutes or less.