CPT code 92242: Retinal angiography, fluorescein and ICG2026 Medicare rate & RVUs in King County, WA

Reports combined fluorescein and indocyanine-green angiography to assess retinal and choroidal circulation in patients with suspected or known vascular disease.

CMS RVU26DEffective Oct 1, 2026One payment locality28K Medicare services in 2024

In King County, WA, Medicare pays $406.65 for 92242 in the office.

$406.65Office (non-facility)
Not available in this settingHospital or facility
+20.9%vs the national office rate ($336.35)

Check a contract rate as a % of Medicare · 92242 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 92242 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 92242 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 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.

How King County, WA compares for 92242

Across 109 of 109 payment localities, the office rate for 92242 runs from $292.84 in Arkansas to $473.49 in San Benito County, CA. King County, WA pays $406.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

92242 in King County, WA vs other payment areas
  1. King County, WA · this page$406.65
  2. Rest of Washington · Washington$352.54−$54.11
  3. Los Angeles, CA · California$392.79−$13.86
  4. Washington, DC area · District of Columbia$392.28−$14.37
  5. Miami, FL · Florida$350.85−$55.80
  6. Chicago, IL · Illinois$339.81−$66.84
  7. Manhattan, NY · New York$388.36−$18.29

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

Every other payment area

92242 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$371.04—
AlabamaAlabama$297.77—
ArkansasArkansas$292.84—
ArizonaArizona$326.73—
Bakersfield, CACalifornia$365.59—
Chico, CACalifornia$365.43—
El Centro, CACalifornia$365.44—
Fresno, CACalifornia$365.43—

92242 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$292.84

$419.46

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

View every state and territory as a table
92242 office rate range by state
State / territoryOffice rate rangeLocalities
AK$371.041
AL$297.771
AR$292.841
AZ$326.731
CA$365.43–$473.4929
CO$355.881
CT$360.651
DC$392.281
DE$332.721
FL$323.65–$350.853
GA$303.78–$341.572
GU$377.431
HI$377.431
IA$309.711
ID$311.331
IL$310.66–$345.804
IN$313.471
KS$306.511
KY$302.501
LA$301.34–$318.602
MA$352.68–$396.442
MD$340.20–$392.283
ME$311.53–$333.122
MI$310.08–$326.632
MN$344.221
MO$294.37–$321.763
MS$293.751
MT$336.341
NC$315.501
ND$335.551
NE$312.111
NH$348.641
NJ$365.68–$387.032
NM$311.391
NV$336.431
NY$320.75–$396.935
OH$309.911
OK$303.531
OR$334.73–$370.242
PA$311.35–$349.632
PR$339.671
RI$346.821
SC$313.051
SD$335.461
TN$308.071
TX$308.90–$353.898
UT$317.971
VA$330.79–$392.282
VI$339.671
VT$332.651
WA$352.54–$406.652
WI$322.661
WV$297.111
WY$336.001

See 92242 in every payment locality

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.

How the rate is built · 92242

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.93

0.93 RVUs× 1.000 GPCI

Practice expense9.10

9.10 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

10.0700

Conversion factor

$33.4009

Medicare rate

$336.35

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

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,719

Code
92242
Physician work
0.93
Practice expense
9.10
Malpractice
0.04

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 92242 in King County, WA
ComponentRVULocality factorAdjusted
Physician work0.93× 1.0500.9765
Practice expense9.10× 1.22711.1657
Malpractice0.04× 0.8170.0327
Total RVUs12.1749
Conversion factor× 33.4009

Office rate, King County, WA$406.65

Office: (0.93 × 1.05 + 9.1 × 1.227 + 0.04 × 0.817) × $33.4009 = $406.65

Open 92242 in the RVU calculator

Payment rules and modifiers for 92242

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

CMS payment indicators · 92242

Retinal angiography, fluorescein and ICG

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

92242 without 26 · national office

$336.35

Retinal angiography, fluorescein and ICG

92242-26 · Professional component

$53.78

Pays only the interpretation and report.

When to use modifier 26

How 92242 has changed in King County, WA

92242 · Office / nonfacility

$406.65

Effective 2026-10-01

The base rate is $28.99 higher than on 2025-10-01, moving from $377.66 to $406.65 (7.7%).

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

    $377.66changed to$406.65

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.95 changed to 0.93
    • Practice expense RVU 8.73 changed to 9.10
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $336.26changed to$377.66

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.44 changed to 8.73

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $330.77changed to$336.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $309.69changed to$330.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.72 changed to 7.44
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853
  5. January 1, 2023

    RVU23A

    $299.02changed to$309.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.38 changed to 6.72
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $300.54changed to$299.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.37 changed to 6.38
    • Malpractice RVU 0.03 changed to 0.05

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $278.33changed to$300.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.74 changed to 6.37
    • Malpractice RVU 0.02 changed to 0.03
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $264.64changed to$278.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.54 changed to 5.74
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $263.11changed to$264.64

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.51 changed to 5.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $259.64changed to$263.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.42 changed to 5.51
    • Malpractice RVU 0.03 changed to 0.02
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$259.64

    Held through RVU17B, RVU17C, RVU17D.

  12. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$406.65Not available in this settingRVU26D
2026-07-01$406.65Not available in this settingRVU26C
2026-04-01$406.65Not available in this settingRVU26B
2026-01-01$406.65Not available in this settingRVU26A
2025-10-01$377.66Not available in this settingRVU25D
2025-07-01$377.66Not available in this settingRVU25C
2025-04-01$377.66Not available in this settingRVU25B
2025-01-01$377.66Not available in this settingRVU25A
2024-10-01$336.26Not available in this settingRVU24D
2024-07-01$336.26Not available in this settingRVU24C
2024-04-01$336.26Not available in this settingRVU24B
2024-03-09$336.26Not available in this settingRVU24AR
2024-01-01$330.77Not available in this settingRVU24A
2023-10-01$309.69Not available in this settingRVU23D
2023-07-01$309.69Not available in this settingRVU23C
2023-04-01$309.69Not available in this settingRVU23B
2023-01-01$309.69Not available in this settingRVU23A
2022-10-01$299.02Not available in this settingRVU22D
2022-07-01$299.02Not available in this settingRVU22C
2022-04-01$299.02Not available in this settingRVU22B
2022-01-01$299.02Not available in this settingRVU22A
2021-10-01$300.54Not available in this settingRVU21D
2021-07-01$300.54Not available in this settingRVU21C
2021-04-01$300.54Not available in this settingRVU21B
2021-01-01$300.54Not available in this settingRVU21A
2020-10-01$278.33Not available in this settingRVU20D
2020-07-01$278.33Not available in this settingRVU20C
2020-04-01$278.33Not available in this settingRVU20B
2020-01-01$278.33Not available in this settingRVU20A
2019-10-01$264.64Not available in this settingRVU19D
2019-07-01$264.64Not available in this settingRVU19C
2019-04-01$264.64Not available in this settingRVU19B
2019-01-01$264.64Not available in this settingRVU19A
2018-10-01$263.11Not available in this settingRVU18D
2018-07-01$263.11Not available in this settingRVU18C
2018-04-01$263.11Not available in this settingRVU18B
2018-01-01$263.11Not available in this settingRVU18AR1
2017-10-01$259.64Not available in this settingRVU17D
2017-07-01$259.64Not available in this settingRVU17C
2017-04-01$259.64Not available in this settingRVU17B
2017-01-01$259.64Not available in this settingRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 92242 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 92242 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

92242 billing questions

When should 92242 be chosen instead of 92235 or 92240?

Use 92242 when both fluorescein and indocyanine-green angiography are performed. Use 92235 for a fluorescein-only study or 92240 for an ICG-only study.

Does 92242 cover one eye or both eyes?

It is priced as a unilateral-or-bilateral service. Modifier 50 does not increase payment.

How are the professional and technical portions reported?

Report the global service without a modifier. Use modifier 26 for the interpretation and report, or modifier TC for the equipment-and-staff portion when billing components separately.

Does the multiple-procedure reduction affect both components?

The ophthalmology diagnostic multiple-procedure reduction applies to the technical component.

What documentation supports reporting 92242?

Document that both dye studies were performed, the clinical reason for assessing retinal and choroidal circulation, the images obtained, and the interpreting clinician’s findings 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 92242PPRRVU2026_Oct_nonQPP.csv, line 11,719 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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