92274 maps localized retinal responses with multifocal stimulation; 92273 measures the broader full-field retinal response.
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CMS RVU26D · Effective 2026-10-01
92274 Multifocal ERG Medicare reimbursement rates in Pennsylvania
Multifocal electroretinography maps localized retinal electrical responses to evaluate suspected macular or other focal retinal dysfunction. Compare 92274 office and facility rates across CMS payment localities in Pennsylvania.
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 92274 in Pennsylvania?
Pennsylvania 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
$86.26–$95.61
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 diagnostic testing
About 92274: Multifocal electroretinography with interpretation
Multifocal electroretinography maps localized retinal electrical responses to evaluate suspected macular or other focal retinal dysfunction.
Multifocal electroretinography (mfERG) records electrical responses from multiple retinal locations in response to a patterned visual stimulus. An ophthalmologist, often a retina specialist, may use the test to evaluate unexplained central visual symptoms, suspected localized retinal dysfunction, or possible toxic maculopathy. Ophthalmic testing staff typically obtain the responses, which the physician interprets and reports in settings such as an eye clinic or hospital outpatient department.
Choose mfERG when the clinical question concerns localized retinal function; full-field ERG (92273) assesses a broader retinal response. Documentation should identify the reason for testing and include the test findings and interpretation. The code represents the bilateral service, so modifier 50 does not increase payment. The service may be billed globally or split into the professional interpretation with modifier 26 and the technical equipment and staff with modifier TC. The ophthalmology diagnostic multiple procedure reduction applies to the technical component.
CMS billing rules for 92274
- 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 RVU0.59 · 21%
- Practice expense (office) RVU2.15 · 78%
- Malpractice RVU0.02 · 1%
4.1K
Medicare services in 2024 · #1988 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.
92274 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
92270 is electro-oculography, a different electrical test used to assess retinal pigment epithelium function; 92274 records localized retinal responses.
92284 evaluates dark adaptation, whereas 92274 records electrical responses across multiple retinal locations.
Compare 92274 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
Metropolitan Philadelphia →
Office / nonfacility
$95.61
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$86.26
Facility
Unavailable
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92274 billing questions
How does 92274 differ from full-field ERG 92273?
Multifocal ERG evaluates responses from multiple localized retinal areas, while 92273 measures a broader, full-field retinal response. Select the test that matches the clinical question and the procedure performed.
Does 92274 include the physician's interpretation?
Yes. The global service includes the test's professional interpretation and technical work; modifier 26 identifies the professional component when billed separately.
Can the technical component be billed separately?
Yes. Modifier TC identifies the equipment and staff portion when the technical service is billed separately. The ophthalmology diagnostic multiple procedure reduction applies to that technical component.
Should modifier 50 be reported for testing both eyes?
The code is priced as bilateral, and modifier 50 does not increase payment.
What documentation supports reporting 92274?
Record the clinical reason for evaluating localized retinal function, the mfERG findings, and the physician's interpretation and report. The documentation should support that multifocal ERG was performed rather than a full-field ERG.
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.
