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CMS RVU26D · Effective 2026-10-01

0509T Pattern ERG Medicare reimbursement rates in Michigan

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 Michigan.

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 Michigan?

Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$72.33–$76.04

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $3.71 per service.

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.

Find 0509T in your payment locality →

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 Michigan, from the same CMS release.

92273

Full-field ERG

With interpretation and report

$114.69–$120.44

Use 0509T for pattern electroretinography. Code 92273 describes full-field ERG, which evaluates a generalized retinal response.

92274

Multifocal ERG

Interpretation and report

$86.03–$90.13

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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 0509TPPRRVU2026_Oct_nonQPP.csv, line 444 (RVU26D)