CPT code 92273: Full-field ERG, with interpretation and report2026 Medicare rate & RVUs in New York
Full-field electroretinography records generalized retinal responses to flashes of light and is reported with the physician’s interpretation and report.
Medicare pays $117.96–$144.42 for 92273 in the office in New York, from Rest of New York to NYC suburbs and Long Island, NY. 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.
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On this page 9 sections
What 92273 covers
Full-field electroretinography (ERG) measures the retina’s electrical response to flashes of light, commonly using electrodes on or near the eye. Ophthalmic staff typically acquire the recordings in an eye clinic or diagnostic testing area, while an ophthalmologist interprets the waveforms and reports the findings. The test helps assess generalized retinal function in conditions such as inherited retinal dystrophies or unexplained visual dysfunction; it is distinct from imaging that depicts retinal anatomy.
Report the test when the full-field recording and interpretation are performed, and document the clinical question, testing protocol, recorded responses, and physician interpretation. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and an unmodified claim represents the global service. The ophthalmology diagnostic multiple-procedure reduction applies to the technical component when multiple applicable tests are billed. The code is priced as bilateral, so modifier 50 does not increase payment.
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 92273 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
5 payment localities
$117.96 to $144.42
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | $141.45 | Unavailable |
| NYC suburbs and Long Island, NY | $144.42 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $133.95 | Unavailable |
| Queens, NY | $143.30 | Unavailable |
| Rest of New York | $117.96 | Unavailable |
How the 92273 rate is calculated
Each of 92273’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 · 92273
RVUs × geographic indexes × conversion factor
Work0.67
0.67 RVUs× 1.000 GPCI
Practice expense2.99
2.99 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
3.6900
Conversion factor
$33.4009
Medicare rate
$123.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92273
The CMS indicators that decide how 92273 is paid alongside other services.
CMS payment indicators · 92273
Full-field ERG, with interpretation and report
| 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
92273 without 26 · national office
$123.25
Full-field ERG, with interpretation and report
92273-26 · Professional component
$34.40
Pays only the interpretation and report.
92273 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92274Multifocal ERGInterpretation and report
- Choose 92273 for a full-field assessment of generalized retinal function. Choose 92274 when the study measures responses across multiple localized retinal areas.
- 92270Electro-oculographyWith interpretation and report
- Code 92270 is electro-oculography, which records changes in the eye’s standing electrical potential; 92273 records flash-evoked retinal responses.
- 92250Fundus photographyRetinal photos with interpretation
- Code 92250 documents fundus appearance photographically. Code 92273 measures retinal electrical function rather than producing retinal images.
92273 billing questions
How does full-field ERG differ from multifocal ERG, code 92274?
Full-field ERG assesses generalized retinal responses to flashes. Multifocal ERG evaluates responses from multiple localized retinal areas.
Can the professional and technical portions be billed separately?
Yes. Use modifier 26 for the interpretation and report, or modifier TC for the equipment and staff. Without either modifier, the claim represents the global service.
Should modifier 50 be added for testing both eyes?
No. CMS prices 92273 as bilateral, and modifier 50 does not increase payment.
What does the multiple-procedure reduction affect?
For applicable multiple ophthalmology diagnostic procedures, the reduction applies to the technical component. It does not apply to the professional component.
What documentation supports reporting 92273?
Document the reason for testing, the full-field protocol and responses, and the interpreting physician’s findings. The record should support that generalized flash-evoked retinal function was evaluated.
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.
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