CPT code 92250: Fundus photography, retinal photos with interpretation2026 Medicare rate & RVUs in Wisconsin
Color or red-free photographs of the retina, optic disc, and posterior pole, reviewed with a written report, document and track posterior segment eye disease.
In Wisconsin, Medicare pays $35.63 for 92250 in the office.
Check a contract rate as a % of Medicare · 92250 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 92250 covers
Fundus photography uses a retinal camera, often after pupil dilation, to capture images of the optic nerve head, macula, retinal vessels, and visible peripheral retina. An ophthalmic photographer or technician acquires the images, and an ophthalmologist or optometrist interprets them and writes a report. It is performed mainly in eye clinics and ophthalmology offices to establish a baseline or monitor conditions such as diabetic retinopathy, age-related macular degeneration, choroidal nevi, retinal vascular occlusions, and glaucomatous optic disc changes.
Report one unit for a session whether one or both eyes are photographed. CMS prices 92250 as bilateral, so modifier 50 does not increase payment. The record should identify the clinical reason, eyes imaged, and interpreted findings. Billing without a component modifier represents the global service; modifier 26 identifies the interpretation, and modifier TC identifies the camera, staff, and other technical work when components are billed separately. When 92250 is performed with other eligible ophthalmology diagnostic tests, the ophthalmology diagnostic multiple procedure reduction applies to its 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 Wisconsin compares for 92250
Across 109 of 109 payment localities, the office rate for 92250 runs from $33.45 in Arkansas to $48.53 in San Benito County, CA. Wisconsin pays $35.63. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Wisconsin · this page$35.63
- Los Angeles, CA · California$41.66+$6.03
- Washington, DC area · District of Columbia$42.02+$6.39
- Miami, FL · Florida$39.06+$3.43
- Chicago, IL · Illinois$38.15+$2.52
- Manhattan, NY · New York$42.09+$6.46
- Alaska · Alaska$44.81+$9.18
Other areas in Wisconsin first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $33.86 | — |
| ArkansasArkansas | $33.45 | — |
| ArizonaArizona | $36.25 | — |
| Bakersfield, CACalifornia | $39.31 | — |
| Chico, CACalifornia | $39.23 | — |
| El Centro, CACalifornia | $39.23 | — |
| Fresno, CACalifornia | $39.23 | — |
| Hanford, CACalifornia | $39.23 | — |
| Madera, CACalifornia | $39.23 | — |
| Merced, CACalifornia | $39.23 | — |
| Modesto, CACalifornia | $39.23 | — |
| Napa, CACalifornia | $45.00 | — |
| Oxnard, CACalifornia | $41.44 | — |
| Redding, CACalifornia | $39.23 | — |
| Rest of CaliforniaCalifornia | $39.23 | — |
| Riverside, CACalifornia | $39.46 | — |
| Sacramento, CACalifornia | $41.05 | — |
| Salinas, CACalifornia | $40.89 | — |
| San Diego, CACalifornia | $41.74 | — |
| Marin County, CACalifornia | $47.54 | — |
| San Francisco, CACalifornia | $47.51 | — |
| San Benito County, CACalifornia | $48.53 | — |
| Santa Clara County, CACalifornia | $48.44 | — |
| San Luis Obispo, CACalifornia | $40.24 | — |
| Santa Cruz, CACalifornia | $42.07 | — |
| Santa Maria, CACalifornia | $41.01 | — |
| Santa Rosa, CACalifornia | $42.49 | — |
| Stockton, CACalifornia | $39.23 | — |
| Vallejo, CACalifornia | $44.97 | — |
| Visalia, CACalifornia | $39.23 | — |
| Yuba City, CACalifornia | $39.23 | — |
| ColoradoColorado | $38.58 | — |
| ConnecticutConnecticut | $39.28 | — |
| DelawareDelaware | $36.79 | — |
| Fort Lauderdale, FLFlorida | $37.92 | — |
| Rest of FloridaFlorida | $36.38 | — |
| Atlanta, GAGeorgia | $37.62 | — |
| Rest of GeorgiaGeorgia | $34.68 | — |
| Hawaii, Guam, HIHawaii | $40.00 | — |
| IowaIowa | $34.68 | — |
| IdahoIdaho | $34.85 | — |
| East St. Louis, ILIllinois | $35.88 | — |
| Rest of IllinoisIllinois | $35.42 | — |
| Suburban Chicago, ILIllinois | $38.31 | — |
| IndianaIndiana | $35.02 | — |
| KansasKansas | $34.50 | — |
| KentuckyKentucky | $34.42 | — |
| New Orleans, LALouisiana | $35.79 | — |
| Rest of LouisianaLouisiana | $34.36 | — |
| Metropolitan Boston, MAMassachusetts | $42.07 | — |
| Rest of MassachusettsMassachusetts | $38.39 | — |
| Baltimore area, MDMaryland | $39.15 | — |
| Rest of MarylandMaryland | $37.43 | — |
| Rest of MaineMaine | $34.95 | — |
| Southern Maine, MEMaine | $36.62 | — |
| Detroit, MIMichigan | $36.71 | — |
| Rest of MichiganMichigan | $35.13 | — |
| MinnesotaMinnesota | $37.28 | — |
| Metropolitan Kansas City, MOMissouri | $35.63 | — |
| Metropolitan St. Louis, MOMissouri | $35.95 | — |
| Rest of MissouriMissouri | $33.83 | — |
| MississippiMississippi | $33.65 | — |
| MontanaMontana | $37.07 | — |
| North CarolinaNorth Carolina | $35.27 | — |
| North DakotaNorth Dakota | $36.68 | — |
| NebraskaNebraska | $34.86 | — |
| New HampshireNew Hampshire | $37.95 | — |
| Northern New JerseyNew Jersey | $41.68 | — |
| Rest of New JerseyNew Jersey | $39.81 | — |
| New MexicoNew Mexico | $35.27 | — |
| NevadaNevada | $36.99 | — |
| NYC suburbs and Long Island, NYNew York | $42.90 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $40.02 | — |
| Queens, NYNew York | $42.46 | — |
| Rest of New YorkNew York | $35.71 | — |
| OhioOhio | $35.05 | — |
| OklahomaOklahoma | $34.42 | — |
| Portland, OROregon | $39.71 | — |
| Rest of OregonOregon | $36.78 | — |
| Metropolitan Philadelphia, PAPennsylvania | $38.40 | — |
| Rest of PennsylvaniaPennsylvania | $35.12 | — |
| Puerto RicoPuerto Rico | $37.32 | — |
| Rhode IslandRhode Island | $38.02 | — |
| South CarolinaSouth Carolina | $35.20 | — |
| South DakotaSouth Dakota | $36.63 | — |
| TennesseeTennessee | $34.64 | — |
| Austin, TXTexas | $38.38 | — |
| Beaumont, TXTexas | $34.92 | — |
| Brazoria, TXTexas | $36.82 | — |
| Dallas, TXTexas | $37.00 | — |
| Fort Worth, TXTexas | $36.78 | — |
| Galveston, TXTexas | $36.90 | — |
| Houston, TXTexas | $37.27 | — |
| Rest of TexasTexas | $35.82 | — |
| UtahUtah | $35.60 | — |
| VirginiaVirginia | $36.48 | — |
| Virgin Islands, VIUnited States Virgin Islands | $37.32 | — |
| VermontVermont | $36.51 | — |
| Rest of WashingtonWashington | $38.32 | — |
| King County, WAWashington | $42.91 | — |
| West VirginiaWest Virginia | $34.30 | — |
| WyomingWyoming | $36.90 | — |
92250 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.
$33.45
$44.81
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $44.81 | 1 |
| AL | $33.86 | 1 |
| AR | $33.45 | 1 |
| AZ | $36.25 | 1 |
| CA | $39.23–$48.53 | 29 |
| CO | $38.58 | 1 |
| CT | $39.28 | 1 |
| DC | $42.02 | 1 |
| DE | $36.79 | 1 |
| FL | $36.38–$39.06 | 3 |
| GA | $34.68–$37.62 | 2 |
| GU | $40.00 | 1 |
| HI | $40.00 | 1 |
| IA | $34.68 | 1 |
| ID | $34.85 | 1 |
| IL | $35.42–$38.31 | 4 |
| IN | $35.02 | 1 |
| KS | $34.50 | 1 |
| KY | $34.42 | 1 |
| LA | $34.36–$35.79 | 2 |
| MA | $38.39–$42.07 | 2 |
| MD | $37.43–$42.02 | 3 |
| ME | $34.95–$36.62 | 2 |
| MI | $35.13–$36.71 | 2 |
| MN | $37.28 | 1 |
| MO | $33.83–$35.95 | 3 |
| MS | $33.65 | 1 |
| MT | $37.07 | 1 |
| NC | $35.27 | 1 |
| ND | $36.68 | 1 |
| NE | $34.86 | 1 |
| NH | $37.95 | 1 |
| NJ | $39.81–$41.68 | 2 |
| NM | $35.27 | 1 |
| NV | $36.99 | 1 |
| NY | $35.71–$42.90 | 5 |
| OH | $35.05 | 1 |
| OK | $34.42 | 1 |
| OR | $36.78–$39.71 | 2 |
| PA | $35.12–$38.40 | 2 |
| PR | $37.32 | 1 |
| RI | $38.02 | 1 |
| SC | $35.20 | 1 |
| SD | $36.63 | 1 |
| TN | $34.64 | 1 |
| TX | $34.92–$38.38 | 8 |
| UT | $35.60 | 1 |
| VA | $36.48–$42.02 | 2 |
| VI | $37.32 | 1 |
| VT | $36.51 | 1 |
| WA | $38.32–$42.91 | 2 |
| WI | $35.63 | 1 |
| WV | $34.30 | 1 |
| WY | $36.90 | 1 |
How the 92250 rate is calculated
Each of 92250’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 · 92250
RVUs × geographic indexes × conversion factor
Work0.39
0.39 RVUs× 1.000 GPCI
Practice expense0.70
0.70 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.1100
Conversion factor
$33.4009
Medicare rate
$37.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Wisconsin inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,722
- Code
- 92250
- Physician work
- 0.39
- Practice expense
- 0.70
- Malpractice
- 0.02
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.39 | × 1.000 | 0.3900 |
| Practice expense | 0.70 | × 0.958 | 0.6706 |
| Malpractice | 0.02 | × 0.308 | 0.0062 |
| Total RVUs | 1.0668 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Wisconsin$35.63
Office: (0.39 × 1 + 0.7 × 0.958 + 0.02 × 0.308) × $33.4009 = $35.63
Payment rules and modifiers for 92250
The CMS indicators that decide how 92250 is paid alongside other services.
CMS payment indicators · 92250
Fundus photography, retinal photos with interpretation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 7 | Diagnostic ophthalmology reduction applies to the technical component. |
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
92250 without 26 · national office
$37.07
Fundus photography, retinal photos with interpretation
92250-26 · Professional component
$20.37
Pays only the interpretation and report.
How 92250 has changed in Wisconsin
92250 · Office / nonfacility
$35.63
Effective 2026-10-01
The base rate is $1.43 higher than on 2025-10-01, moving from $34.20 to $35.63 (4.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$34.20changed to$35.63
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.40 changed to 0.39
- Practice expense RVU 0.68 changed to 0.70
- Practice expense GPCI 0.957 changed to 0.958
- Malpractice GPCI 0.331 changed to 0.308
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$35.52changed to$34.20
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.69 changed to 0.68
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$34.94changed to$35.52
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$35.98changed to$34.94
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.950 changed to 0.957
- Malpractice GPCI 0.314 changed to 0.331
January 1, 2023
RVU23A
$35.89changed to$35.98
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.67 changed to 0.69
- Practice expense GPCI 0.942 changed to 0.950
- Malpractice GPCI 0.296 changed to 0.314
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$37.83changed to$35.89
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.72 changed to 0.67
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$43.78changed to$37.83
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.85 changed to 0.72
- Practice expense GPCI 0.949 changed to 0.942
- Malpractice GPCI 0.322 changed to 0.296
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$49.50changed to$43.78
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.01 changed to 0.85
- Practice expense GPCI 0.957 changed to 0.949
- Malpractice GPCI 0.347 changed to 0.322
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$55.99changed to$49.50
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.20 changed to 1.01
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$64.09changed to$55.99
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.44 changed to 1.20
- Practice expense GPCI 0.956 changed to 0.957
- Malpractice GPCI 0.457 changed to 0.347
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$76.34changed to$64.09
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 0.44 changed to 0.40
- Practice expense RVU 1.76 changed to 1.44
- Practice expense GPCI 0.955 changed to 0.956
- Malpractice GPCI 0.566 changed to 0.457
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$76.61changed to$76.34
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$76.23changed to$76.61
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$76.22changed to$76.23
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.75 changed to 1.76
- Practice expense GPCI 0.958 changed to 0.955
- Malpractice GPCI 0.557 changed to 0.566
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$76.22
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $35.63 | Not available in this setting | RVU26D |
| 2026-07-01 | $35.63 | Not available in this setting | RVU26C |
| 2026-04-01 | $35.63 | Not available in this setting | RVU26B |
| 2026-01-01 | $35.63 | Not available in this setting | RVU26A |
| 2025-10-01 | $34.20 | Not available in this setting | RVU25D |
| 2025-07-01 | $34.20 | Not available in this setting | RVU25C |
| 2025-04-01 | $34.20 | Not available in this setting | RVU25B |
| 2025-01-01 | $34.20 | Not available in this setting | RVU25A |
| 2024-10-01 | $35.52 | Not available in this setting | RVU24D |
| 2024-07-01 | $35.52 | Not available in this setting | RVU24C |
| 2024-04-01 | $35.52 | Not available in this setting | RVU24B |
| 2024-03-09 | $35.52 | Not available in this setting | RVU24AR |
| 2024-01-01 | $34.94 | Not available in this setting | RVU24A |
| 2023-10-01 | $35.98 | Not available in this setting | RVU23D |
| 2023-07-01 | $35.98 | Not available in this setting | RVU23C |
| 2023-04-01 | $35.98 | Not available in this setting | RVU23B |
| 2023-01-01 | $35.98 | Not available in this setting | RVU23A |
| 2022-10-01 | $35.89 | Not available in this setting | RVU22D |
| 2022-07-01 | $35.89 | Not available in this setting | RVU22C |
| 2022-04-01 | $35.89 | Not available in this setting | RVU22B |
| 2022-01-01 | $35.89 | Not available in this setting | RVU22A |
| 2021-10-01 | $37.83 | Not available in this setting | RVU21D |
| 2021-07-01 | $37.83 | Not available in this setting | RVU21C |
| 2021-04-01 | $37.83 | Not available in this setting | RVU21B |
| 2021-01-01 | $37.83 | Not available in this setting | RVU21A |
| 2020-10-01 | $43.78 | Not available in this setting | RVU20D |
| 2020-07-01 | $43.78 | Not available in this setting | RVU20C |
| 2020-04-01 | $43.78 | Not available in this setting | RVU20B |
| 2020-01-01 | $43.78 | Not available in this setting | RVU20A |
| 2019-10-01 | $49.50 | Not available in this setting | RVU19D |
| 2019-07-01 | $49.50 | Not available in this setting | RVU19C |
| 2019-04-01 | $49.50 | Not available in this setting | RVU19B |
| 2019-01-01 | $49.50 | Not available in this setting | RVU19A |
| 2018-10-01 | $55.99 | Not available in this setting | RVU18D |
| 2018-07-01 | $55.99 | Not available in this setting | RVU18C |
| 2018-04-01 | $55.99 | Not available in this setting | RVU18B |
| 2018-01-01 | $55.99 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $64.09 | Not available in this setting | RVU17D |
| 2017-07-01 | $64.09 | Not available in this setting | RVU17C |
| 2017-04-01 | $64.09 | Not available in this setting | RVU17B |
| 2017-01-01 | $64.09 | Not available in this setting | RVU17A |
| 2016-10-01 | $76.34 | Not available in this setting | RVU16D |
| 2016-07-01 | $76.34 | Not available in this setting | RVU16C |
| 2016-04-01 | $76.34 | Not available in this setting | RVU16B |
| 2016-01-01 | $76.34 | Not available in this setting | RVU16A |
| 2015-10-01 | $76.61 | Not available in this setting | RVU15D |
| 2015-07-01 | $76.61 | Not available in this setting | RVU15C |
| 2015-04-01 | $76.23 | Not available in this setting | RVU15B |
| 2015-01-01 | $76.23 | Not available in this setting | RVU15A |
| 2014-10-01 | $76.22 | Not available in this setting | RVU14D |
| 2014-07-01 | $76.22 | Not available in this setting | RVU14C |
| 2014-04-01 | $76.22 | Not available in this setting | RVU14B |
| 2014-01-01 | $76.22 | Not available in this setting | RVU14A |
| 2013-10-01 | Additional calculation required | Not available in this setting | RVU13D |
| 2013-07-01 | Additional calculation required | Not available in this setting | RVU13C |
| 2013-04-01 | Additional calculation required | Not available in this setting | RVU13B |
| 2013-01-01 | Additional calculation required | Not available in this setting | RVU13AR |
Where the Wisconsin rate applies
Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.
- Abbotsford
- Abrams
- Adams
- Adell
- Albany
- Algoma
- Allens Grove
- Allenton
92250 billing questions
Should fundus photography be billed once or twice when both eyes are photographed?
Once. The code is priced as bilateral, so a single unit covers one or both eyes, and modifier 50 does not increase payment.
Can fundus photography and extended ophthalmoscopy be billed on the same date?
Same-day billing requires separately performed, medically necessary services supported by their own documentation. Fundus photographs alone do not establish the extended examination and detailed drawing required for 92201 or 92202.
When is 92250 used instead of retinal imaging codes 92227–92229?
Use 92250 for diagnostic fundus photographs with a clinical interpretation and report. Codes 92227 and 92228 describe remote retinal imaging with different reviewers; 92229 describes point-of-care imaging with automated analysis. Select the code that matches the service performed rather than reporting both for the same images.
How is the service split between an imaging site and the reading clinician?
The entity furnishing the camera and staff reports the technical service with modifier TC; the clinician who interprets the images and reports findings uses modifier 26. An entity furnishing both components reports the global service without either modifier.
Does a multiple procedure reduction affect fundus photography?
When 92250 is performed with other tests subject to the ophthalmology diagnostic multiple procedure reduction, CMS applies the reduction to the technical component.
What documentation supports the interpretation portion?
A signed interpretation should identify the indication and eyes imaged and describe relevant findings, such as hemorrhages, drusen, or optic disc cupping. Note image quality or comparisons with prior photographs when they affect interpretation.
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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