CPT code 92260: Ophthalmic test2026 Medicare rate & RVUs
Report ophthalmodynamometry when an ophthalmic clinician measures retinal arterial pressure using controlled pressure applied to the eye.
Medicare pays $18.70 for 92260 nationally in the office and $9.02 in a hospital or facility. Local office rates run $16.89–$24.45.
Medicare rate · 92260
Ophthalmic test
- Work RVUs
- 0.2
- Total RVUs
- 0.56
- Global days
- XXX
National rate · 2026
$18.70
Office setting, before claim adjustments.
See every locality for 92260 →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.
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On this page 10 sections
What 92260 covers
Ophthalmodynamometry uses a specialized instrument to apply controlled pressure to the eye while the clinician observes retinal artery pulsation and estimates retinal arterial pressure. An ophthalmologist or other qualified eye-care professional may perform the test during an ophthalmic evaluation when retinal circulation or suspected carotid occlusive disease is being assessed. It is a pressure measurement, not retinal photography or dye-based imaging.
Report 92260 for the documented pressure-measurement service. The record should support why the test was performed and identify the findings or interpretation; an image or general retinal examination alone does not establish that ophthalmodynamometry occurred. CMS prices the code as bilateral, so report it once for the service and do not expect modifier 50 to 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 92260 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
$16.89 to $24.45
109 of 109 payment localities
92260 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.
$16.89
$22.65
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 | $22.65 | 1 |
| AL | $17.10 | 1 |
| AR | $16.89 | 1 |
| AZ | $18.29 | 1 |
| CA | $19.79–$24.45 | 29 |
| CO | $19.46 | 1 |
| CT | $19.81 | 1 |
| DC | $21.18 | 1 |
| DE | $18.56 | 1 |
| FL | $18.36–$19.69 | 3 |
| GA | $17.51–$18.98 | 2 |
| GU | $20.17 | 1 |
| HI | $20.17 | 1 |
| IA | $17.51 | 1 |
| ID | $17.59 | 1 |
| IL | $17.88–$19.32 | 4 |
| IN | $17.68 | 1 |
| KS | $17.42 | 1 |
| KY | $17.38 | 1 |
| LA | $17.35–$18.06 | 2 |
| MA | $19.36–$21.21 | 2 |
| MD | $18.88–$21.18 | 3 |
| ME | $17.64–$18.48 | 2 |
| MI | $17.73–$18.52 | 2 |
| MN | $18.81 | 1 |
| MO | $17.08–$18.14 | 3 |
| MS | $16.99 | 1 |
| MT | $18.70 | 1 |
| NC | $17.80 | 1 |
| ND | $18.51 | 1 |
| NE | $17.60 | 1 |
| NH | $19.14 | 1 |
| NJ | $20.08–$21.02 | 2 |
| NM | $17.80 | 1 |
| NV | $18.66 | 1 |
| NY | $18.02–$21.63 | 5 |
| OH | $17.69 | 1 |
| OK | $17.38 | 1 |
| OR | $18.56–$20.02 | 2 |
| PA | $17.73–$19.37 | 2 |
| PR | $18.83 | 1 |
| RI | $19.18 | 1 |
| SC | $17.77 | 1 |
| SD | $18.48 | 1 |
| TN | $17.49 | 1 |
| TX | $17.63–$19.36 | 8 |
| UT | $17.97 | 1 |
| VA | $18.41–$21.18 | 2 |
| VI | $18.83 | 1 |
| VT | $18.42 | 1 |
| WA | $19.33–$21.63 | 2 |
| WI | $17.98 | 1 |
| WV | $17.32 | 1 |
| WY | $18.62 | 1 |
How the 92260 rate is calculated
Each of 92260’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 · 92260
RVUs × geographic indexes × conversion factor
Work0.20
0.20 RVUs× 1.000 GPCI
Practice expense0.35
0.35 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.5600
Conversion factor
$33.4009
Medicare rate
$18.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92260
The CMS indicators that decide how 92260 is paid alongside other services.
CMS payment indicators · 92260
Ophthalmic test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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 | 0 | Physician service: no professional/technical split. |
92260 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92235Fluorescein angiography
- 92235 uses fluorescein imaging to assess retinal vascular findings; 92260 measures retinal arterial pressure through controlled pressure on the eye.
- 92250Fundus photography
- 92250 documents the fundus photographically. It does not measure retinal arterial pressure as 92260 does.
- 93880Carotid duplex
- 93880 is a bilateral extracranial carotid duplex study. Choose it for ultrasound evaluation of carotid arteries, not for ophthalmodynamometry.
92260 billing questions
When should 92260 be selected instead of retinal imaging?
Use 92260 when the clinician measures retinal arterial pressure with an ophthalmodynamometer. Fundus photography and fluorescein angiography document different findings and do not substitute for that pressure measurement.
Should modifier 50 be appended?
CMS prices 92260 as bilateral. Modifier 50 does not increase payment.
What documentation supports reporting the service?
Document the clinical reason for assessing retinal arterial pressure, performance of the pressure measurement, and the resulting findings or interpretation.
Can retinal photographs be reported as 92260?
No. 92260 represents pressure measurement; retinal photographs are a separate imaging service when performed and supported.
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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