CPT code 92202: Extended ophthalmoscopy, optic nerve or macula drawing2026 Medicare rate & RVUs in Texas
Detailed examination of the optic nerve or macula with a drawing, interpretation, and report when findings need documentation beyond a routine fundus exam.
Medicare pays $15.04–$16.08 for 92202 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 92202 covers
Extended ophthalmoscopy focuses on the optic nerve head or macula rather than the peripheral retina. An ophthalmologist or optometrist examines the area in detail, usually after dilation with a slit lamp lens or indirect ophthalmoscope, and makes a labeled drawing of findings such as glaucomatous cupping, disc edema, or macular hemorrhage. The examination may be performed during an office eye visit or in a facility when posterior pole findings require documentation beyond a routine fundus check.
Report 92202 when the record contains the optic nerve or macula drawing, an interpretation and report, and a clinical reason for the extended examination, such as evaluating glaucoma or a macular abnormality. A narrative description, fundus image, or OCT printout alone does not substitute for the drawing. The code covers one or both eyes; report one unit for the examination rather than separate units for each eye. CMS already prices 92202 as bilateral, so modifier 50 does not increase payment. For a drawing of peripheral retinal disease with scleral depression, select 92201 instead.
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.
Where 92202 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$15.04 to $16.08
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $16.08 | $11.84 |
| Beaumont, TX | $15.04 | $11.40 |
| Brazoria, TX | $15.63 | $11.66 |
| Dallas, TX | $15.70 | $11.71 |
| Fort Worth, TX | $15.63 | $11.68 |
| Galveston, TX | $15.66 | $11.68 |
| Houston, TX | $15.84 | $11.86 |
| Rest of Texas | $15.31 | $11.50 |
How the 92202 rate is calculated
Each of 92202’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 · 92202
RVUs × geographic indexes × conversion factor
Work0.25
0.25 RVUs× 1.000 GPCI
Practice expense0.21
0.21 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.4700
Conversion factor
$33.4009
Medicare rate
$15.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92202
The CMS indicators that decide how 92202 is paid alongside other services.
CMS payment indicators · 92202
Extended ophthalmoscopy, optic nerve or macula 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. |
92202 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 92201Extended ophthalmoscopyRetinal drawing
- 92201 covers drawing peripheral retinal disease with scleral depression; 92202 covers drawing the optic nerve or macula. Select by the area and examination performed.
- 92250Fundus photographyRetinal photos with interpretation
- 92250 produces fundus photographs with interpretation. 92202 requires a drawing of optic nerve or macula findings from direct examination, with interpretation and report.
- 92134Retinal OCTPosterior segment, retina
- 92134 is cross-sectional OCT imaging of the retina. 92202 is a direct examination with a drawing of the optic nerve or macula; an OCT printout does not support 92202.
- 92014Comprehensive eye examEstablished patient
- 92014 is a comprehensive eye exam that includes a routine fundus evaluation. Report 92202 as well only when a medically necessary extended optic nerve or macula examination and drawing are documented.
92202 billing questions
How do I choose between 92202 and 92201?
Use 92202 when the drawing documents the optic nerve or macula. Use 92201 when the drawing maps peripheral retinal disease, such as a tear or detachment, with scleral depression.
Should I report 92202 with modifier 50 or with RT and LT when both eyes are drawn?
Report a single unit for one or both eyes. CMS already prices the code as bilateral, so modifier 50 does not increase payment.
Can 92202 be billed on the same day as an eye exam or E/M visit?
Yes, when the extended examination is separately medically necessary and documented beyond the routine fundus evaluation in the eye exam or E/M visit.
What documentation supports 92202?
A labeled drawing of the optic nerve or macula, an interpretation and report, and a reason the detailed examination was needed. A narrative note alone does not satisfy the drawing requirement.
Can a fundus photograph or OCT printout replace the drawing?
No. Those images document different services and do not satisfy the drawing requirement for extended ophthalmoscopy.
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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