Billing code 92242: Retinal angiographyMedicare rate & RVUs
Reports combined fluorescein and indocyanine-green angiography to assess retinal and choroidal circulation in patients with suspected or known vascular disease.
Medicare pays $336.35 for 92242 nationally in the office. Local office rates run $292.84–$473.49.
Medicare rate · 92242
Retinal angiography
Swap in your local Medicare rate.
- Work RVUs
- 0.93
- Total RVUs
- 10.07
- Global days
- XXX
National rate · 2026
$336.35
Office setting, before claim adjustments.
See every locality for 92242 → · Billed by an NP, PA or therapist? →
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 10 sections
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
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$292.84 to $473.49
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $297.77 | Unavailable |
| Alaska* | $371.04 | Unavailable |
| Arizona | $326.73 | Unavailable |
| Arkansas | $292.84 | Unavailable |
| Atlanta | $341.57 | Unavailable |
| Austin | $353.89 | Unavailable |
| Bakersfield | $365.59 | Unavailable |
| Baltimore/Surr. Cntys | $359.35 | Unavailable |
| Beaumont | $308.90 | Unavailable |
| Brazoria | $333.57 | Unavailable |
| Chicago | $339.81 | Unavailable |
| Chico | $365.43 | Unavailable |
| Colorado | $355.88 | Unavailable |
| Connecticut | $360.65 | Unavailable |
| Dallas | $335.22 | Unavailable |
| Dc + Md/Va Suburbs | $392.28 | Unavailable |
| Delaware | $332.72 | Unavailable |
| Detroit | $326.63 | Unavailable |
| East St. Louis | $313.39 | Unavailable |
| El Centro | $365.44 | Unavailable |
| Fort Lauderdale | $341.38 | Unavailable |
| Fort Worth | $332.20 | Unavailable |
| Fresno | $365.43 | Unavailable |
| Galveston | $334.24 | Unavailable |
| Hanford-Corcoran | $365.43 | Unavailable |
| Hawaii, Guam | $377.43 | Unavailable |
| Houston | $334.97 | Unavailable |
| Idaho | $311.33 | Unavailable |
| Indiana | $313.47 | Unavailable |
| Iowa | $309.71 | Unavailable |
| Kansas | $306.51 | Unavailable |
| Kentucky | $302.50 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $392.79 | Unavailable |
| Madera | $365.43 | Unavailable |
| Manhattan | $388.36 | Unavailable |
| Merced | $365.43 | Unavailable |
| Metropolitan Boston | $396.44 | Unavailable |
| Metropolitan Kansas City | $317.78 | Unavailable |
| Metropolitan Philadelphia | $349.63 | Unavailable |
| Metropolitan St. Louis | $321.76 | Unavailable |
| Miami | $350.85 | Unavailable |
| Minnesota | $344.22 | Unavailable |
| Mississippi | $293.75 | Unavailable |
| Modesto | $365.43 | Unavailable |
| Montana** | $336.34 | Unavailable |
| Napa | $434.30 | Unavailable |
| Nebraska | $312.11 | Unavailable |
| Nevada** | $336.43 | Unavailable |
| New Hampshire | $348.64 | Unavailable |
| New Mexico | $311.39 | Unavailable |
| New Orleans | $318.60 | Unavailable |
| North Carolina | $315.50 | Unavailable |
| North Dakota** | $335.55 | Unavailable |
| Northern Nj | $387.03 | Unavailable |
| Nyc Suburbs/Long Island | $396.93 | Unavailable |
| Ohio | $309.91 | Unavailable |
| Oklahoma | $303.53 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $392.03 | Unavailable |
| Portland | $370.24 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $366.90 | Unavailable |
| Puerto Rico | $339.67 | Unavailable |
| Queens | $394.24 | Unavailable |
| Redding | $365.43 | Unavailable |
| Rest Of California | $365.43 | Unavailable |
| Rest Of Florida | $323.65 | Unavailable |
| Rest Of Georgia | $303.78 | Unavailable |
| Rest Of Illinois | $310.66 | Unavailable |
| Rest Of Louisiana | $301.34 | Unavailable |
| Rest Of Maine | $311.53 | Unavailable |
| Rest Of Maryland | $340.20 | Unavailable |
| Rest Of Massachusetts | $352.68 | Unavailable |
| Rest Of Michigan | $310.08 | Unavailable |
| Rest Of Missouri | $294.37 | Unavailable |
| Rest Of New Jersey | $365.68 | Unavailable |
| Rest Of New York | $320.75 | Unavailable |
| Rest Of Oregon | $334.73 | Unavailable |
| Rest Of Pennsylvania | $311.35 | Unavailable |
| Rest Of Texas | $320.72 | Unavailable |
| Rest Of Washington | $352.54 | Unavailable |
| Rhode Island | $346.82 | Unavailable |
| Riverside-San Bernardino-Ontario | $365.89 | Unavailable |
| Sacramento-Roseville-Folsom | $386.39 | Unavailable |
| Salinas | $385.02 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $396.24 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $463.19 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $463.15 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $473.49 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $473.30 | Unavailable |
| San Luis Obispo-Paso Robles | $378.50 | Unavailable |
| Santa Cruz-Watsonville | $401.73 | Unavailable |
| Santa Maria-Santa Barbara | $387.05 | Unavailable |
| Santa Rosa-Petaluma | $405.96 | Unavailable |
| Seattle (King Cnty) | $406.65 | Unavailable |
| South Carolina | $313.05 | Unavailable |
| South Dakota** | $335.46 | Unavailable |
| Southern Maine | $333.12 | Unavailable |
| Stockton | $365.43 | Unavailable |
| Suburban Chicago | $345.80 | Unavailable |
| Tennessee | $308.07 | Unavailable |
| Utah | $317.97 | Unavailable |
| Vallejo | $434.24 | Unavailable |
| Vermont | $332.65 | Unavailable |
| Virgin Islands | $339.67 | Unavailable |
| Virginia | $330.79 | Unavailable |
| Visalia | $365.43 | Unavailable |
| West Virginia | $297.11 | Unavailable |
| Wisconsin | $322.66 | Unavailable |
| Wyoming** | $336.00 | Unavailable |
| Yuba City | $365.43 | Unavailable |
92242 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.
$292.84
$419.46
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 | $371.04 | 1 |
| AL | $297.77 | 1 |
| AR | $292.84 | 1 |
| AZ | $326.73 | 1 |
| CA | $365.43–$473.49 | 29 |
| CO | $355.88 | 1 |
| CT | $360.65 | 1 |
| DC | $392.28 | 1 |
| DE | $332.72 | 1 |
| FL | $323.65–$350.85 | 3 |
| GA | $303.78–$341.57 | 2 |
| GU | $377.43 | 1 |
| HI | $377.43 | 1 |
| IA | $309.71 | 1 |
| ID | $311.33 | 1 |
| IL | $310.66–$345.80 | 4 |
| IN | $313.47 | 1 |
| KS | $306.51 | 1 |
| KY | $302.50 | 1 |
| LA | $301.34–$318.60 | 2 |
| MA | $352.68–$396.44 | 2 |
| MD | $340.20–$392.28 | 3 |
| ME | $311.53–$333.12 | 2 |
| MI | $310.08–$326.63 | 2 |
| MN | $344.22 | 1 |
| MO | $294.37–$321.76 | 3 |
| MS | $293.75 | 1 |
| MT | $336.34 | 1 |
| NC | $315.50 | 1 |
| ND | $335.55 | 1 |
| NE | $312.11 | 1 |
| NH | $348.64 | 1 |
| NJ | $365.68–$387.03 | 2 |
| NM | $311.39 | 1 |
| NV | $336.43 | 1 |
| NY | $320.75–$396.93 | 5 |
| OH | $309.91 | 1 |
| OK | $303.53 | 1 |
| OR | $334.73–$370.24 | 2 |
| PA | $311.35–$349.63 | 2 |
| PR | $339.67 | 1 |
| RI | $346.82 | 1 |
| SC | $313.05 | 1 |
| SD | $335.46 | 1 |
| TN | $308.07 | 1 |
| TX | $308.90–$353.89 | 8 |
| UT | $317.97 | 1 |
| VA | $330.79–$392.28 | 2 |
| VI | $339.67 | 1 |
| VT | $332.65 | 1 |
| WA | $352.54–$406.65 | 2 |
| WI | $322.66 | 1 |
| WV | $297.11 | 1 |
| WY | $336.00 | 1 |
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
Swap in your local Medicare rate.
Work 0.93Practice expense 9.10Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92242
The CMS indicators that decide how 92242 is paid alongside other services.
CMS payment indicators · 92242
Retinal angiography
| 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
92242 without 26 · national office
$336.35
Retinal angiography
92242-26 · Professional component
$53.78
Pays only the interpretation and report.
92242 compared with similar codes
Compare codes
92242 vs 92235 vs 92240 vs 92250: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 92235Fluorescein angiography
- 92235 represents fluorescein angiography alone. Choose 92242 when the encounter includes both fluorescein and ICG angiography.
- 92240ICG angiography
- 92240 represents ICG angiography alone. Choose 92242 when fluorescein angiography is also performed.
- 92250Fundus photography
- 92250 is fundus photography, not dye-based angiography. It does not replace 92242 when both angiographic studies are performed.
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
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