$24.15–$25.11
92201 covers drawing peripheral retinal disease with scleral depression; 92202 covers drawing the optic nerve or macula. Select by the area and examination performed.
On this page
CMS RVU26D · Effective 2026-10-01
92202 Extended ophthalmoscopy Medicare reimbursement rates in Michigan
Detailed examination of the optic nerve or macula with a drawing, interpretation, and report when findings need documentation beyond a routine fundus exam. Compare 92202 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 92202 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
$15.13–$15.68
2 of 2 localities have a supported rate.
Facility setting
$11.47–$11.81
2 of 2 localities have a 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 92202: Extended ophthalmoscopy with optic nerve or macula drawing
Detailed examination of the optic nerve or macula with a drawing, interpretation, and report when findings need documentation beyond a routine fundus exam.
Extended ophthalmoscopy focuses on the optic nerve head or macula rather than the peripheral retina. An ophthalmologist or optometrist examines the area in detail, usually after dilation with a slit lamp lens or indirect ophthalmoscope, and makes a labeled drawing of findings such as glaucomatous cupping, disc edema, or macular hemorrhage. The examination may be performed during an office eye visit or in a facility when posterior pole findings require documentation beyond a routine fundus check.
Report 92202 when the record contains the optic nerve or macula drawing, an interpretation and report, and a clinical reason for the extended examination, such as evaluating glaucoma or a macular abnormality. A narrative description, fundus image, or OCT printout alone does not substitute for the drawing. The code covers one or both eyes; report one unit for the examination rather than separate units for each eye. CMS already prices 92202 as bilateral, so modifier 50 does not increase payment. For a drawing of peripheral retinal disease with scleral depression, select 92201 instead.
CMS billing rules for 92202
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.25 · 53%
- Practice expense (office) RVU0.21 · 45%
- Malpractice RVU0.01 · 2%
648K
Medicare services in 2024 · #194 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.
92202 compared with similar codes
Office rates for Michigan, from the same CMS release.
$35.13–$36.71
92250 produces fundus photographs with interpretation. 92202 requires a drawing of optic nerve or macula findings from direct examination, with interpretation and report.
$30.93–$32.43
92134 is cross-sectional OCT imaging of the retina. 92202 is a direct examination with a drawing of the optic nerve or macula; an OCT printout does not support 92202.
$120.60–$125.43
92014 is a comprehensive eye exam that includes a routine fundus evaluation. Report 92202 as well only when a medically necessary extended optic nerve or macula examination and drawing are documented.
Compare 92202 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
Detroit →
Office / nonfacility
$15.68
Facility
$11.81
Rest Of Michigan →
Office / nonfacility
$15.13
Facility
$11.47
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92202 billing questions
How do I choose between 92202 and 92201?
Use 92202 when the drawing documents the optic nerve or macula. Use 92201 when the drawing maps peripheral retinal disease, such as a tear or detachment, with scleral depression.
Should I report 92202 with modifier 50 or with RT and LT when both eyes are drawn?
Report a single unit for one or both eyes. CMS already prices the code as bilateral, so modifier 50 does not increase payment.
Can 92202 be billed on the same day as an eye exam or E/M visit?
Yes, when the extended examination is separately medically necessary and documented beyond the routine fundus evaluation in the eye exam or E/M visit.
What documentation supports 92202?
A labeled drawing of the optic nerve or macula, an interpretation and report, and a reason the detailed examination was needed. A narrative note alone does not satisfy the drawing requirement.
Can a fundus photograph or OCT printout replace the drawing?
No. Those images document different services and do not satisfy the drawing requirement for extended ophthalmoscopy.
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.
11,70392145,26,Corneal hysteresis deter,A,,0.10,0.06,,0.06,,0.01,0.17,0.17,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,70492145,TC,Corneal hysteresis deter,A,,0.00,0.23,,0.23,NA,0.01,0.24,0.24,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
11,70592201,,Opscpy extnd rta draw uni/bi,A,,0.39,0.34,,0.14,,0.02,0.75,0.55,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,70692202,,Opscpy extnd on/mac draw,A,,0.25,0.21,,0.09,,0.01,0.47,0.35,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,70792227,,Img rta detcj/mntr ds staff,A,,0.00,0.55,,0.55,NA,0.01,0.56,0.56,3,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,1.77,1.77,0.03
11,70892228,,Img rta detc/mntr ds phy/qhp,A,,0.31,0.58,,0.58,NA,0.02,0.91,0.91,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,1.29,1.29,0.04
11,70992228,26,Img rta detc/mntr ds phy/qhp,A,,0.31,0.17,,0.17,,0.01,0.49,0.49,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00