$112.08
Use 0509T for pattern electroretinography. Code 92273 describes full-field ERG, which evaluates a generalized retinal response.
On this page
CMS RVU26D · Effective 2026-10-01
0509T Pattern ERG Medicare reimbursement rates in Kentucky
Pattern electroretinography records retinal responses to a visual pattern and is reported when the test and its interpretation assess retinal ganglion-cell function. Compare 0509T office and facility rates across CMS payment localities in Kentucky.
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 0509T in Kentucky?
Kentucky 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
$70.65
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 testing
About 0509T: Pattern electroretinography with interpretation
Pattern electroretinography records retinal responses to a visual pattern and is reported when the test and its interpretation assess retinal ganglion-cell function.
Pattern electroretinography (PERG) records electrical responses from the retina while the patient views a changing visual pattern. Ophthalmologists and other eye-care specialists use it to assess retinal ganglion-cell function, including in the evaluation of glaucoma or suspected optic nerve-related dysfunction. The service is commonly performed in an ophthalmology office and includes interpretation and a report when billed globally.
Report 0509T for the pattern-based retinal test, rather than a full-field or multifocal ERG. The record should identify the test performed and include the interpreted findings and report. Modifier 26 represents the professional interpretation; modifier TC represents the equipment and staff. Billing without either modifier represents the global service. CMS prices the service as bilateral, so modifier 50 does not increase payment. When multiple ophthalmology diagnostic tests are reported, the multiple-procedure reduction applies to the technical component.
CMS billing rules for 0509T
- 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 · 17%
- Practice expense (office) RVU1.92 · 82%
- Malpractice RVU0.02 · 1%
9.3K
Medicare services in 2024 · #1513 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.
0509T compared with similar codes
Office rates for Kentucky, from the same CMS release.
$84.16
Use 0509T for pattern-based retinal stimulation. Code 92274 is for multifocal ERG, which evaluates responses from multiple retinal areas.
Compare 0509T 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
Kentucky →
Office / nonfacility
$70.65
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 0509T in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
444
- Code
- 0509T
- Physician work
- 0.39
- Practice expense
- 1.92
- Malpractice
- 0.02
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.39 | × 1.000 | 0.3900 |
| Practice expense | 1.92 | × 0.889 | 1.7069 |
| Malpractice | 0.02 | × 0.915 | 0.0183 |
| Total RVUs | 2.1152 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$70.65
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.39 | 1 |
| Practice expense | 1.92 | 0.889 |
| Malpractice | 0.02 | 0.915 |
(0.39 × 1 + 1.92 × 0.889 + 0.02 × 0.915) × $33.4009 = $70.65
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.
0509T billing questions
How does 0509T differ from a full-field ERG?
0509T is for pattern electroretinography, which assesses retinal responses to a visual pattern. A full-field ERG evaluates a more generalized retinal response and is reported with 92273.
Does 0509T include the interpretation?
Yes. The global service includes the technical test and professional interpretation with report. Modifier 26 identifies the professional component alone, and modifier TC identifies the technical component alone.
Should modifier 50 be added when both eyes are tested?
No. CMS prices 0509T as bilateral, and modifier 50 does not increase payment.
Can 0509T be reported with other ophthalmic diagnostic tests?
It may be reported with other tests when each distinct service is performed and documented. The ophthalmology diagnostic multiple-procedure reduction applies to the technical component.
What documentation supports 0509T?
Document that pattern electroretinography was performed and retain the interpreted findings and report. The documentation should support the professional interpretation when billing modifier 26.
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.
4410507T,26,Near ifr 2img mibmn glnd i&r,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,7,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4420507T,TC,Near ifr 2img mibmn glnd i&r,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,7,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
4430509F,,Urine incon plan docd,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4440509T,,Pattern erg w/i&r,A,,0.39,1.92,,1.92,NA,0.02,2.33,2.33,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4450509T,26,Pattern erg w/i&r,A,,0.39,0.23,,0.23,,0.01,0.63,0.63,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4460509T,TC,Pattern erg w/i&r,A,,0.00,1.69,,1.69,NA,0.01,1.70,1.70,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
4470510T,,Rmvl sinus tarsi implant,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631