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

Remote retinal imaging with physician or qualified health care professional interpretation supports detection or monitoring of retinal disease, including diabetic retinopathy.

CMS RVU26DEffective Oct 1, 2026One payment locality13.4K Medicare services in 2024

In Utah, Medicare pays $29.16 for 92228 in the office.

$29.16Office (non-facility)
Not available in this settingHospital or facility
−4.0%vs the national office rate ($30.39)

Check a contract rate as a % of Medicare · 92228 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 92228 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 92228 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Utah compares for 92228

Across 109 of 109 payment localities, the office rate for 92228 runs from $27.34 in Arkansas to $39.79 in San Benito County, CA. Utah pays $29.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

92228 in Utah vs other payment areas
  1. Utah · this page$29.16
  2. Los Angeles, CA · California$34.14+$4.98
  3. Washington, DC area · District of Columbia$34.48+$5.32
  4. Miami, FL · Florida$32.21+$3.05
  5. Chicago, IL · Illinois$31.43+$2.27
  6. Manhattan, NY · New York$34.59+$5.43
  7. Alaska · Alaska$36.53+$7.37

Other areas in Utah first, then benchmark localities. Bars start at $0.

Every other payment area

92228 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$27.68—
ArkansasArkansas$27.34—
ArizonaArizona$29.70—
Bakersfield, CACalifornia$32.19—
Chico, CACalifornia$32.12—
El Centro, CACalifornia$32.12—
Fresno, CACalifornia$32.12—
Hanford, CACalifornia$32.12—

92228 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.

$27.34

$36.53

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92228 office rate range by state
State / territoryOffice rate rangeLocalities
AK$36.531
AL$27.681
AR$27.341
AZ$29.701
CA$32.12–$39.7929
CO$31.611
CT$32.231
DC$34.481
DE$30.151
FL$29.88–$32.213
GA$28.43–$30.872
GU$32.771
HI$32.771
IA$28.351
ID$28.491
IL$29.09–$31.514
IN$28.641
KS$28.201
KY$28.191
LA$28.14–$29.342
MA$31.45–$34.502
MD$30.68–$34.483
ME$28.59–$29.972
MI$28.80–$30.182
MN$30.491
MO$27.70–$29.473
MS$27.531
MT$30.391
NC$28.861
ND$30.001
NE$28.491
NH$31.111
NJ$32.66–$34.192
NM$28.921
NV$30.301
NY$29.23–$35.295
OH$28.711
OK$28.171
OR$30.12–$32.542
PA$28.77–$31.502
PR$30.601
RI$31.161
SC$28.821
SD$29.951
TN$28.321
TX$28.60–$31.468
UT$29.161
VA$29.87–$34.482
VI$30.601
VT$29.871
WA$31.40–$35.192
WI$29.121
WV$28.141
WY$30.221

See 92228 in every payment locality

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.

How the rate is built · 92228

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.31

0.31 RVUs× 1.000 GPCI

Practice expense0.58

0.58 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.9100

Conversion factor

$33.4009

Medicare rate

$30.39

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,708

Code
92228
Physician work
0.31
Practice expense
0.58
Malpractice
0.02

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 92228 in Utah
ComponentRVULocality factorAdjusted
Physician work0.31× 1.0000.3100
Practice expense0.58× 0.9400.5452
Malpractice0.02× 0.8980.0180
Total RVUs0.8732
Conversion factor× 33.4009

Office rate, Utah$29.16

Office: (0.31 × 1 + 0.58 × 0.94 + 0.02 × 0.898) × $33.4009 = $29.16

Open 92228 in the RVU calculator

Payment rules and modifiers for 92228

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

CMS payment indicators · 92228

Retinal imaging, physician or QHP interpretation

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures7Diagnostic ophthalmology reduction applies to the technical component.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

92228 without 26 · national office

$30.39

Retinal imaging, physician or QHP interpretation

92228-26 · Professional component

$16.37

Pays only the interpretation and report.

When to use modifier 26

How 92228 has changed in Utah

92228 · Office / nonfacility

$29.16

Effective 2026-10-01

The base rate is $1.61 higher than on 2025-10-01, moving from $27.55 to $29.16 (5.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $27.55changed to$29.16

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.32 changed to 0.31
    • Practice expense RVU 0.55 changed to 0.58
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $28.35changed to$27.55

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $27.89changed to$28.35

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $28.06changed to$27.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.53 changed to 0.55
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $29.44changed to$28.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.56 changed to 0.53
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $29.36changed to$29.44

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.55 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $33.05changed to$29.36

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.37 changed to 0.32
    • Practice expense RVU 0.57 changed to 0.55
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $33.55changed to$33.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.58 changed to 0.57
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $33.18changed to$33.55

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.57 changed to 0.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $33.70changed to$33.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.59 changed to 0.57
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $33.23changed to$33.70

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.58 changed to 0.59
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $34.35changed to$33.23

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.61 changed to 0.58

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $34.17changed to$34.35

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $33.82changed to$34.17

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.60 changed to 0.61
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $34.22changed to$33.82

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.67 changed to 0.60
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $34.22

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$29.16Not available in this settingRVU26D
2026-07-01$29.16Not available in this settingRVU26C
2026-04-01$29.16Not available in this settingRVU26B
2026-01-01$29.16Not available in this settingRVU26A
2025-10-01$27.55Not available in this settingRVU25D
2025-07-01$27.55Not available in this settingRVU25C
2025-04-01$27.55Not available in this settingRVU25B
2025-01-01$27.55Not available in this settingRVU25A
2024-10-01$28.35Not available in this settingRVU24D
2024-07-01$28.35Not available in this settingRVU24C
2024-04-01$28.35Not available in this settingRVU24B
2024-03-09$28.35Not available in this settingRVU24AR
2024-01-01$27.89Not available in this settingRVU24A
2023-10-01$28.06Not available in this settingRVU23D
2023-07-01$28.06Not available in this settingRVU23C
2023-04-01$28.06Not available in this settingRVU23B
2023-01-01$28.06Not available in this settingRVU23A
2022-10-01$29.44Not available in this settingRVU22D
2022-07-01$29.44Not available in this settingRVU22C
2022-04-01$29.44Not available in this settingRVU22B
2022-01-01$29.44Not available in this settingRVU22A
2021-10-01$29.36Not available in this settingRVU21D
2021-07-01$29.36Not available in this settingRVU21C
2021-04-01$29.36Not available in this settingRVU21B
2021-01-01$29.36Not available in this settingRVU21A
2020-10-01$33.05Not available in this settingRVU20D
2020-07-01$33.05Not available in this settingRVU20C
2020-04-01$33.05Not available in this settingRVU20B
2020-01-01$33.05Not available in this settingRVU20A
2019-10-01$33.55Not available in this settingRVU19D
2019-07-01$33.55Not available in this settingRVU19C
2019-04-01$33.55Not available in this settingRVU19B
2019-01-01$33.55Not available in this settingRVU19A
2018-10-01$33.18Not available in this settingRVU18D
2018-07-01$33.18Not available in this settingRVU18C
2018-04-01$33.18Not available in this settingRVU18B
2018-01-01$33.18Not available in this settingRVU18AR1
2017-10-01$33.70Not available in this settingRVU17D
2017-07-01$33.70Not available in this settingRVU17C
2017-04-01$33.70Not available in this settingRVU17B
2017-01-01$33.70Not available in this settingRVU17A
2016-10-01$33.23Not available in this settingRVU16D
2016-07-01$33.23Not available in this settingRVU16C
2016-04-01$33.23Not available in this settingRVU16B
2016-01-01$33.23Not available in this settingRVU16A
2015-10-01$34.35Not available in this settingRVU15D
2015-07-01$34.35Not available in this settingRVU15C
2015-04-01$34.17Not available in this settingRVU15B
2015-01-01$34.17Not available in this settingRVU15A
2014-10-01$33.82Not available in this settingRVU14D
2014-07-01$33.82Not available in this settingRVU14C
2014-04-01$33.82Not available in this settingRVU14B
2014-01-01$33.82Not available in this settingRVU14A
2013-10-01$34.22Not available in this settingRVU13D
2013-07-01$34.22Not available in this settingRVU13C
2013-04-01$34.22Not available in this settingRVU13B
2013-01-01$34.22Not available in this settingRVU13AR

Price 92228 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

92228 billing questions

How does 92228 differ from 92227?

Use 92228 when a physician or other qualified health care professional interprets the retinal images and reports the findings. Use 92227 for remote review and reporting by clinical staff.

How does 92228 differ from 92229?

92228 involves clinician interpretation and reporting. 92229 describes imaging analyzed and reported through point-of-care automated analysis.

Can the professional and technical components be billed separately?

Yes. Modifier 26 identifies the interpretation and report, while modifier TC identifies the equipment and staff portion. Billing without either modifier represents the global service.

Should modifier 50 be reported when both eyes are imaged?

No. 92228 is priced as a bilateral service, and modifier 50 does not increase payment.

When does the multiple procedure reduction affect 92228?

The ophthalmology diagnostic multiple procedure reduction applies to the technical component. It does not apply to the professional component.

What documentation supports reporting 92228?

Document the clinical reason for retinal imaging, the images obtained, and the physician’s or qualified health care professional’s interpretation and report.

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
RVUs for 92228PPRRVU2026_Oct_nonQPP.csv, line 11,708 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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