CPT code 92201: Extended ophthalmoscopy, retinal drawing2026 Medicare rate & RVUs in Kentucky
Report 92201 for an extended examination of the retina with a documented drawing, interpretation, and report, for one or both eyes.
In Kentucky, Medicare pays $23.73 for 92201 in the office and $17.79 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 92201 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 92201 covers
An ophthalmologist or other qualified eye-care professional performs an extended examination of the retina and records the findings in a retinal drawing. Typical reasons include evaluating or documenting retinal detachment or a retinal melanoma. The service involves more than routine ophthalmoscopy: the record should show the retinal findings examined and include the drawing and the clinician’s interpretation and report.
Select 92201 when the documented drawing concerns the retina; use the related code 92202 when the drawing concerns the optic nerve or macula. The code covers unilateral or bilateral service. CMS prices it as bilateral, so modifier 50 does not increase payment. Documentation should identify the eye or eyes examined, the clinical findings, and the drawing and report supporting the extended examination.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Kentucky compares for 92201
Across 109 of 109 payment localities, the office rate for 92201 runs from $23.13 in Arkansas to $32.00 in Alaska. Kentucky pays $23.73. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Kentucky · this page$23.73
- Los Angeles, CA · California$27.44+$3.71
- Washington, DC area · District of Columbia$27.85+$4.12
- Miami, FL · Florida$26.54+$2.81
- Chicago, IL · Illinois$26.06+$2.33
- Manhattan, NY · New York$28.12+$4.39
- Alaska · Alaska$32.00+$8.27
Other areas in Kentucky first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $23.34 | $17.50 |
| ArkansasArkansas | $23.13 | $17.39 |
| ArizonaArizona | $24.60 | $18.13 |
| Bakersfield, CACalifornia | $26.13 | $18.81 |
| Chico, CACalifornia | $26.05 | $18.73 |
| El Centro, CACalifornia | $26.06 | $18.73 |
| Fresno, CACalifornia | $26.05 | $18.73 |
| Hanford, CACalifornia | $26.05 | $18.73 |
| Madera, CACalifornia | $26.05 | $18.73 |
| Merced, CACalifornia | $26.05 | $18.73 |
| Modesto, CACalifornia | $26.05 | $18.73 |
| Napa, CACalifornia | $29.15 | $20.35 |
| Oxnard, CACalifornia | $27.23 | $19.33 |
| Redding, CACalifornia | $26.05 | $18.73 |
| Rest of CaliforniaCalifornia | $26.05 | $18.73 |
| Riverside, CACalifornia | $26.28 | $18.96 |
| Sacramento, CACalifornia | $27.06 | $19.29 |
| Salinas, CACalifornia | $26.95 | $19.21 |
| San Diego, CACalifornia | $27.36 | $19.37 |
| Marin County, CACalifornia | $30.58 | $21.16 |
| San Francisco, CACalifornia | $30.56 | $21.14 |
| San Benito County, CACalifornia | $31.19 | $21.56 |
| Santa Clara County, CACalifornia | $31.10 | $21.47 |
| San Luis Obispo, CACalifornia | $26.54 | $18.93 |
| Santa Cruz, CACalifornia | $27.46 | $19.34 |
| Santa Maria, CACalifornia | $26.99 | $19.20 |
| Santa Rosa, CACalifornia | $27.72 | $19.52 |
| Stockton, CACalifornia | $26.05 | $18.73 |
| Vallejo, CACalifornia | $29.12 | $20.32 |
| Visalia, CACalifornia | $26.05 | $18.73 |
| Yuba City, CACalifornia | $26.05 | $18.73 |
| ColoradoColorado | $25.79 | $18.68 |
| ConnecticutConnecticut | $26.33 | $19.13 |
| DelawareDelaware | $24.91 | $18.31 |
| Fort Lauderdale, FLFlorida | $25.74 | $18.97 |
| Rest of FloridaFlorida | $24.89 | $18.50 |
| Atlanta, GAGeorgia | $25.41 | $18.62 |
| Rest of GeorgiaGeorgia | $23.95 | $17.99 |
| Hawaii, Guam, HIHawaii | $26.33 | $18.73 |
| IowaIowa | $23.68 | $17.57 |
| IdahoIdaho | $23.79 | $17.64 |
| East St. Louis, ILIllinois | $24.82 | $18.67 |
| Rest of IllinoisIllinois | $24.44 | $18.34 |
| Suburban Chicago, ILIllinois | $25.96 | $19.10 |
| IndianaIndiana | $23.88 | $17.69 |
| KansasKansas | $23.63 | $17.59 |
| New Orleans, LALouisiana | $24.47 | $18.19 |
| Rest of LouisianaLouisiana | $23.72 | $17.80 |
| Metropolitan Boston, MAMassachusetts | $27.71 | $19.74 |
| Rest of MassachusettsMassachusetts | $25.73 | $18.69 |
| Baltimore area, MDMaryland | $26.25 | $19.08 |
| Rest of MarylandMaryland | $25.26 | $18.50 |
| Rest of MaineMaine | $23.89 | $17.74 |
| Southern Maine, MEMaine | $24.70 | $18.08 |
| Detroit, MIMichigan | $25.11 | $18.67 |
| Rest of MichiganMichigan | $24.15 | $18.05 |
| MinnesotaMinnesota | $24.91 | $18.04 |
| Metropolitan Kansas City, MOMissouri | $24.34 | $18.07 |
| Metropolitan St. Louis, MOMissouri | $24.51 | $18.15 |
| Rest of MissouriMissouri | $23.47 | $17.71 |
| MississippiMississippi | $23.30 | $17.55 |
| MontanaMontana | $25.05 | $18.37 |
| North CarolinaNorth Carolina | $24.05 | $17.82 |
| North DakotaNorth Dakota | $24.65 | $17.97 |
| NebraskaNebraska | $23.76 | $17.59 |
| New HampshireNew Hampshire | $25.43 | $18.48 |
| Northern New JerseyNew Jersey | $27.73 | $19.98 |
| Rest of New JerseyNew Jersey | $26.68 | $19.39 |
| New MexicoNew Mexico | $24.24 | $18.12 |
| NevadaNevada | $24.95 | $18.26 |
| NYC suburbs and Long Island, NYNew York | $28.60 | $20.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $26.86 | $19.54 |
| Queens, NYNew York | $28.25 | $20.35 |
| Rest of New YorkNew York | $24.28 | $17.94 |
| OhioOhio | $24.07 | $17.97 |
| OklahomaOklahoma | $23.69 | $17.72 |
| Portland, OROregon | $26.35 | $18.93 |
| Rest of OregonOregon | $24.81 | $18.15 |
| Metropolitan Philadelphia, PAPennsylvania | $25.88 | $18.93 |
| Rest of PennsylvaniaPennsylvania | $24.08 | $17.95 |
| Puerto RicoPuerto Rico | $25.17 | $18.41 |
| Rhode IslandRhode Island | $25.60 | $18.70 |
| South CarolinaSouth Carolina | $24.09 | $17.91 |
| South DakotaSouth Dakota | $24.61 | $17.93 |
| TennesseeTennessee | $23.71 | $17.64 |
| Austin, TXTexas | $25.66 | $18.59 |
| Beaumont, TXTexas | $23.98 | $17.90 |
| Brazoria, TXTexas | $24.91 | $18.29 |
| Dallas, TXTexas | $25.03 | $18.37 |
| Fort Worth, TXTexas | $24.92 | $18.34 |
| Galveston, TXTexas | $24.96 | $18.33 |
| Houston, TXTexas | $25.33 | $18.69 |
| Rest of TexasTexas | $24.41 | $18.07 |
| UtahUtah | $24.30 | $18.02 |
| VirginiaVirginia | $24.66 | $18.09 |
| Virgin Islands, VIUnited States Virgin Islands | $25.17 | $18.41 |
| VermontVermont | $24.61 | $17.99 |
| Rest of WashingtonWashington | $25.66 | $18.63 |
| King County, WAWashington | $28.16 | $19.96 |
| WisconsinWisconsin | $24.11 | $17.71 |
| West VirginiaWest Virginia | $23.85 | $18.05 |
| WyomingWyoming | $24.88 | $18.20 |
92201 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$23.13
$32.00
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $32.00 | 1 |
| AL | $23.34 | 1 |
| AR | $23.13 | 1 |
| AZ | $24.60 | 1 |
| CA | $26.05–$31.19 | 29 |
| CO | $25.79 | 1 |
| CT | $26.33 | 1 |
| DC | $27.85 | 1 |
| DE | $24.91 | 1 |
| FL | $24.89–$26.54 | 3 |
| GA | $23.95–$25.41 | 2 |
| GU | $26.33 | 1 |
| HI | $26.33 | 1 |
| IA | $23.68 | 1 |
| ID | $23.79 | 1 |
| IL | $24.44–$26.06 | 4 |
| IN | $23.88 | 1 |
| KS | $23.63 | 1 |
| KY | $23.73 | 1 |
| LA | $23.72–$24.47 | 2 |
| MA | $25.73–$27.71 | 2 |
| MD | $25.26–$27.85 | 3 |
| ME | $23.89–$24.70 | 2 |
| MI | $24.15–$25.11 | 2 |
| MN | $24.91 | 1 |
| MO | $23.47–$24.51 | 3 |
| MS | $23.30 | 1 |
| MT | $25.05 | 1 |
| NC | $24.05 | 1 |
| ND | $24.65 | 1 |
| NE | $23.76 | 1 |
| NH | $25.43 | 1 |
| NJ | $26.68–$27.73 | 2 |
| NM | $24.24 | 1 |
| NV | $24.95 | 1 |
| NY | $24.28–$28.60 | 5 |
| OH | $24.07 | 1 |
| OK | $23.69 | 1 |
| OR | $24.81–$26.35 | 2 |
| PA | $24.08–$25.88 | 2 |
| PR | $25.17 | 1 |
| RI | $25.60 | 1 |
| SC | $24.09 | 1 |
| SD | $24.61 | 1 |
| TN | $23.71 | 1 |
| TX | $23.98–$25.66 | 8 |
| UT | $24.30 | 1 |
| VA | $24.66–$27.85 | 2 |
| VI | $25.17 | 1 |
| VT | $24.61 | 1 |
| WA | $25.66–$28.16 | 2 |
| WI | $24.11 | 1 |
| WV | $23.85 | 1 |
| WY | $24.88 | 1 |
How the 92201 rate is calculated
Each of 92201’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 92201
RVUs × geographic indexes × conversion factor
Work0.39
0.39 RVUs× 1.000 GPCI
Practice expense0.34
0.34 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.7500
Conversion factor
$33.4009
Medicare rate
$25.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Kentucky inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,705
- Code
- 92201
- Physician work
- 0.39
- Practice expense
- 0.34
- Malpractice
- 0.02
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.39 | × 1.000 | 0.3900 |
| Practice expense | 0.34 | × 0.889 | 0.3023 |
| Malpractice | 0.02 | × 0.915 | 0.0183 |
| Total RVUs | 0.7106 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Kentucky$23.73
Office: (0.39 × 1 + 0.34 × 0.889 + 0.02 × 0.915) × $33.4009 = $23.73
Facility: (0.39 × 1 + 0.14 × 0.889 + 0.02 × 0.915) × $33.4009 = $17.79
Payment rules and modifiers for 92201
The CMS indicators that decide how 92201 is paid alongside other services.
CMS payment indicators · 92201
Extended ophthalmoscopy, retinal drawing
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 92201 has changed in Kentucky
92201 · Office / nonfacility
$23.73
Effective 2026-10-01
The base rate is $1.12 higher than on 2025-10-01, moving from $22.61 to $23.73 (5.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$22.61changed to$23.73
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.40 changed to 0.39
- Practice expense RVU 0.32 changed to 0.34
- Practice expense GPCI 0.877 changed to 0.889
- Malpractice GPCI 0.913 changed to 0.915
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$23.26changed to$22.61
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$22.88changed to$23.26
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$23.32changed to$22.88
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.31 changed to 0.32
- Practice expense GPCI 0.873 changed to 0.877
- Malpractice GPCI 0.870 changed to 0.913
January 1, 2023
RVU23A
$23.44changed to$23.32
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.30 changed to 0.31
- Practice expense GPCI 0.869 changed to 0.873
- Malpractice GPCI 0.827 changed to 0.870
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$23.63changed to$23.44
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$24.18changed to$23.63
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.29 changed to 0.30
- Practice expense GPCI 0.874 changed to 0.869
- Malpractice GPCI 0.823 changed to 0.827
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$24.18
Held through RVU20B, RVU20C, RVU20D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $23.73 | $17.79 | RVU26D |
| 2026-07-01 | $23.73 | $17.79 | RVU26C |
| 2026-04-01 | $23.73 | $17.79 | RVU26B |
| 2026-01-01 | $23.73 | $17.79 | RVU26A |
| 2025-10-01 | $22.61 | $20.62 | RVU25D |
| 2025-07-01 | $22.61 | $20.62 | RVU25C |
| 2025-04-01 | $22.61 | $20.62 | RVU25B |
| 2025-01-01 | $22.61 | $20.62 | RVU25A |
| 2024-10-01 | $23.26 | $21.22 | RVU24D |
| 2024-07-01 | $23.26 | $21.22 | RVU24C |
| 2024-04-01 | $23.26 | $21.22 | RVU24B |
| 2024-03-09 | $23.26 | $21.22 | RVU24AR |
| 2024-01-01 | $22.88 | $20.87 | RVU24A |
| 2023-10-01 | $23.32 | $21.24 | RVU23D |
| 2023-07-01 | $23.32 | $21.24 | RVU23C |
| 2023-04-01 | $23.32 | $21.24 | RVU23B |
| 2023-01-01 | $23.32 | $21.24 | RVU23A |
| 2022-10-01 | $23.44 | $21.63 | RVU22D |
| 2022-07-01 | $23.44 | $21.63 | RVU22C |
| 2022-04-01 | $23.44 | $21.63 | RVU22B |
| 2022-01-01 | $23.44 | $21.63 | RVU22A |
| 2021-10-01 | $23.63 | $21.81 | RVU21D |
| 2021-07-01 | $23.63 | $21.81 | RVU21C |
| 2021-04-01 | $23.63 | $21.81 | RVU21B |
| 2021-01-01 | $23.63 | $21.81 | RVU21A |
| 2020-10-01 | $24.18 | $22.28 | RVU20D |
| 2020-07-01 | $24.18 | $22.28 | RVU20C |
| 2020-04-01 | $24.18 | $22.28 | RVU20B |
| 2020-01-01 | $24.18 | $22.28 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Kentucky rate applies
Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.
- Adairville
- Ages
- Albany
- Alexandria
- Allen
- Allensville
- Anchorage
- Annville
92201 billing questions
How is 92201 different from 92202?
92201 is for an extended examination with a retinal drawing. 92202 is for a drawing of the optic nerve or macula.
Can 92201 be reported for both eyes?
Yes. The code covers unilateral or bilateral service, and CMS prices it as bilateral. Modifier 50 does not increase payment.
What documentation supports 92201?
Document the eye or eyes examined, the retinal findings, and the drawing, interpretation, and report. A routine eye examination without the retinal drawing and report does not describe this service.
Is a retinal photograph the same service as 92201?
No. 92201 describes an extended ophthalmoscopic examination with a retinal drawing and report. Fundus photography, reported with 92250, records the retina photographically.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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