$28.64
92228 covers remote retinal imaging for disease detection or monitoring with physician or qualified professional review. Use 92250 for diagnostic fundus photographs with interpretation and report; do not report both for the same images.
On this page
CMS RVU26D · Effective 2026-10-01
92250 Fundus photography Medicare reimbursement rates in Indiana
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. Compare 92250 office and facility rates across CMS payment localities in Indiana.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92250 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$35.02
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmology diagnostic
About 92250: Fundus photography with interpretation and report
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.
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.
CMS billing rules for 92250
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Ophthalmology diagnostic multiple procedure reduction applies to the technical component.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.39 · 35%
- Practice expense (office) RVU0.70 · 63%
- Malpractice RVU0.02 · 2%
3.5M
Medicare services in 2024 · #55 by national volume
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.
92250 compared with similar codes
Office rates for Indiana, from the same CMS release.
$23.88
92201 is an extended retinal examination documented with a detailed drawing; 92250 documents the fundus with photographs. If both are performed, each needs separate clinical support and documentation.
$151.96
92235 uses fluorescein dye and sequential angiographic images to assess retinal circulation and leakage; 92250 captures non-contrast color or red-free fundus photographs.
$21.81
92285 photographs external ocular structures such as the eyelids, conjunctiva, or cornea; 92250 images the internal fundus, including the optic disc, macula, vessels, and visible periphery.
Compare 92250 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
$35.02
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92250 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
11,722
- Code
- 92250
- Physician work
- 0.39
- Practice expense
- 0.70
- Malpractice
- 0.02
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.39 | × 1.000 | 0.3900 |
| Practice expense | 0.70 | × 0.927 | 0.6489 |
| Malpractice | 0.02 | × 0.486 | 0.0097 |
| Total RVUs | 1.0486 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$35.02
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.39 | 1 |
| Practice expense | 0.7 | 0.927 |
| Malpractice | 0.02 | 0.486 |
(0.39 × 1 + 0.7 × 0.927 + 0.02 × 0.486) × $33.4009 = $35.02
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,71992242,,Fluorescein&icg angiography,A,,0.93,9.10,,9.10,NA,0.04,10.07,10.07,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72092242,26,Fluorescein&icg angiography,A,,0.93,0.65,,0.65,,0.03,1.61,1.61,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72192242,TC,Fluorescein&icg angiography,A,,0.00,8.45,,8.45,NA,0.01,8.46,8.46,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,72292250,,Fundus photography w/i&r,A,,0.39,0.70,,0.70,NA,0.02,1.11,1.11,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,4.20,4.20,0.09
11,72392250,26,Fundus photography w/i&r,A,,0.39,0.21,,0.21,,0.01,0.61,0.61,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72492250,TC,Fundus photography w/i&r,A,,0.00,0.49,,0.49,NA,0.01,0.50,0.50,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,3.99,3.99,0.08
11,72592260,,Ophthalmodynamometry,A,,0.20,0.35,,0.06,,0.01,0.56,0.27,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915