CPT code 92242: Retinal angiography, fluorescein and ICG2026 Medicare rate & RVUs in California

Medicare pays $365.43–$473.49 for 92242 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 92242 covers

This service combines two dye-based imaging studies of the back of the eye. After dye is administered, images show blood flow through the retinal and choroidal vessels; fluorescein highlights retinal circulation, while indocyanine green helps assess the choroid. Ophthalmologists, often retina specialists, use the findings in evaluations such as retinal vascular disease or neovascular age-related macular degeneration. The service includes interpretation and a report and may be performed in an office or facility setting.

Report 92242 when both angiographic studies are performed for the encounter; use the appropriate single-study code when only one dye study is done. The code covers unilateral or bilateral imaging, so modifier 50 does not increase payment. Submit the global service without a component modifier, or report the interpretation with modifier 26 and the equipment-and-staff service with modifier TC. When multiple ophthalmology diagnostic procedures are reported, the 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 92242 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 92242 rate is calculated

Each of 92242’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 92242

The CMS indicators that decide how 92242 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

92242 compared with similar codes

How to choose

92235Fluorescein angiographyMultiframe retinal imaging

92235 represents fluorescein angiography alone. Choose 92242 when the encounter includes both fluorescein and ICG angiography.

92240ICG angiographyUnilateral or bilateral

92240 represents ICG angiography alone. Choose 92242 when fluorescein angiography is also performed.

92250Fundus photographyRetinal photos with interpretation

92250 is fundus photography, not dye-based angiography. It does not replace 92242 when both angiographic studies are performed.

Codes related to 92242

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