CPT code 92228: Retinal imaging, physician or QHP interpretation2026 Medicare rate & RVUs in California

Medicare pays $32.12–$39.79 for 92228 in the office in California, from Chico, CA to San Benito County, CA. 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.

What 92228 covers

This service covers retinal images acquired for remote detection or monitoring of disease, such as diabetic retinopathy, and reviewed by a physician or other qualified health care professional who provides an interpretation and report. Clinic staff typically capture the images with a retinal camera; the interpreting clinician may review them away from the imaging site. The service fits screening or surveillance workflows focused on retinal disease, rather than a comprehensive eye examination.

Select 92228 when a physician or qualified health care professional interprets the images; 92227 describes remote staff review, while 92229 uses point-of-care automated analysis. Documentation should support the clinical reason for imaging and include the image findings and interpreting clinician’s report. The code is priced for one or both eyes, so modifier 50 does not increase payment. The global service includes the professional and technical components; modifier 26 identifies interpretation, and modifier TC identifies the equipment and staff portion. The ophthalmology diagnostic multiple procedure reduction applies to the technical component.

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 92228 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 92228 rate is calculated

Each of 92228’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.

Payment rules and modifiers for 92228

The CMS indicators that decide how 92228 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

92228 compared with similar codes

How to choose

92227Retinal imagingStaff-acquired detection

The distinction is who reviews and reports the images: 92228 involves a physician or qualified health care professional, while 92227 describes clinical staff review.

92229Retinal imagingAutonomous point-of-care analysis

Choose 92229 for point-of-care automated analysis and reporting. Choose 92228 when a physician or qualified health care professional interprets the images and reports findings.

92250Fundus photographyRetinal photos with interpretation

92250 describes fundus photography with interpretation and report. 92228 is for retinal imaging used in remote disease detection or monitoring workflows.

92201Extended ophthalmoscopyRetinal drawing

92201 involves extended ophthalmoscopy with retinal drawing. 92228 reports remote image-based retinal disease detection or monitoring with clinician interpretation.

Codes related to 92228

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates