$17.15–$18.29
The distinction is who reviews and reports the images: 92228 involves a physician or qualified health care professional, while 92227 describes clinical staff review.
On this page
CMS RVU26D · Effective 2026-10-01
92228 Retinal imaging Medicare reimbursement rates in Michigan
Remote retinal imaging with physician or qualified health care professional interpretation supports detection or monitoring of retinal disease, including diabetic retinopathy. Compare 92228 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 92228 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
$28.80–$30.18
2 of 2 localities have a supported rate.
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.
Ophthalmic imaging
About 92228: Remote retinal imaging with clinician interpretation
Remote retinal imaging with physician or qualified health care professional interpretation supports detection or monitoring of retinal disease, including diabetic retinopathy.
This service covers retinal images acquired for remote detection or monitoring of disease, such as diabetic retinopathy, and reviewed by a physician or other qualified health care professional who provides an interpretation and report. Clinic staff typically capture the images with a retinal camera; the interpreting clinician may review them away from the imaging site. The service fits screening or surveillance workflows focused on retinal disease, rather than a comprehensive eye examination.
Select 92228 when a physician or qualified health care professional interprets the images; 92227 describes remote staff review, while 92229 uses point-of-care automated analysis. Documentation should support the clinical reason for imaging and include the image findings and interpreting clinician’s report. The code is priced for one or both eyes, so modifier 50 does not increase payment. The global service includes the professional and technical components; modifier 26 identifies interpretation, and modifier TC identifies the equipment and staff portion. The ophthalmology diagnostic multiple procedure reduction applies to the technical component.
CMS billing rules for 92228
- 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 RVU0.31 · 34%
- Practice expense (office) RVU0.58 · 64%
- Malpractice RVU0.02 · 2%
13.4K
Medicare services in 2024 · #1322 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.
92228 compared with similar codes
Office rates for Michigan, from the same CMS release.
$42.77–$45.37
Choose 92229 for point-of-care automated analysis and reporting. Choose 92228 when a physician or qualified health care professional interprets the images and reports findings.
$35.13–$36.71
92250 describes fundus photography with interpretation and report. 92228 is for retinal imaging used in remote disease detection or monitoring workflows.
$24.15–$25.11
92201 involves extended ophthalmoscopy with retinal drawing. 92228 reports remote image-based retinal disease detection or monitoring with clinician interpretation.
Compare 92228 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
$30.18
Facility
Unavailable
Rest Of Michigan →
Office / nonfacility
$28.80
Facility
Unavailable
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92228 billing questions
How does 92228 differ from 92227?
Use 92228 when a physician or other qualified health care professional interprets the retinal images and reports the findings. Use 92227 for remote review and reporting by clinical staff.
How does 92228 differ from 92229?
92228 involves clinician interpretation and reporting. 92229 describes imaging analyzed and reported through point-of-care automated analysis.
Can the professional and technical components be billed separately?
Yes. Modifier 26 identifies the interpretation and report, while modifier TC identifies the equipment and staff portion. Billing without either modifier represents the global service.
Should modifier 50 be reported when both eyes are imaged?
No. 92228 is priced as a bilateral service, and modifier 50 does not increase payment.
When does the multiple procedure reduction affect 92228?
The ophthalmology diagnostic multiple procedure reduction applies to the technical component. It does not apply to the professional component under the CMS rule supplied for this code.
What documentation supports reporting 92228?
Document the clinical reason for retinal imaging, the images obtained, and the physician’s or qualified health care professional’s interpretation and report.
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.
11,70592201,,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
11,71092228,TC,Img rta detc/mntr ds phy/qhp,A,,0.00,0.41,,0.41,NA,0.01,0.42,0.42,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,1.12,1.12,0.03
11,71192229,,Img rta detc/mntr ds poc aly,A,,0.00,1.39,,1.39,NA,0.01,1.40,1.40,3,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,1.79,1.79,0.01