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CMS RVU26D · Effective 2026-10-01

92286 Specular microscopy Medicare reimbursement rates in Pennsylvania

Reports specular microscopy of the corneal endothelium, including image acquisition and interpretation to assess endothelial cell density and appearance. Compare 92286 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 92286 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

$37.27–$40.83

2 of 2 localities have a supported rate.

Lowest: Rest Of Pennsylvania

Highest: Metropolitan Philadelphia

A spread of $3.56 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 92286 in your payment locality →

Ophthalmic diagnostic testing

About 92286: Corneal endothelial specular microscopy

Reports specular microscopy of the corneal endothelium, including image acquisition and interpretation to assess endothelial cell density and appearance.

Specular microscopy captures magnified images of the corneal endothelium, allowing assessment of endothelial cell density, size, and shape. Ophthalmologists commonly use it when evaluating corneal endothelial disorders, such as Fuchs dystrophy, or assessing endothelial reserve before a procedure that may affect the cornea. The test is generally performed in an eye-care setting with a specular microscope, and the service includes interpretation and a report.

Report the code when the record supports medically necessary anterior-segment endothelial imaging and documents the findings and their clinical significance. The service may be billed globally, or divided between the professional interpretation and technical image acquisition using modifier 26 or TC. Medicare applies its ophthalmology diagnostic multiple-procedure reduction to the technical component. The code is priced as bilateral, so modifier 50 does not increase payment.

CMS billing rules for 92286

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 · 33%
  • Practice expense (office) RVU0.77 · 65%
  • Malpractice RVU0.02 · 2%

102.7K

Medicare services in 2024 · #549 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.

92286 compared with similar codes

Office rates for Pennsylvania, from the same CMS release.

92287

Eye angiography

Anterior segment

$125.27–$140.62

92286 uses specular microscopy to assess the corneal endothelium. 92287 is anterior-segment imaging with fluorescein angiography.

92285

External eye photography

External structures

$21.93–$24.75

92285 captures external ocular photographs. Choose 92286 when the service is specular imaging of corneal endothelial cells.

92250

Fundus photography

Retinal photos with interpretation

$35.12–$38.40

92250 documents the fundus, including posterior-segment structures. 92286 evaluates the corneal endothelium in the anterior segment.

Compare 92286 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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92286 billing questions

When should this code be chosen over 92287?

Use 92286 for specular microscopy focused on the corneal endothelium. Code 92287 describes anterior-segment imaging using fluorescein angiography.

Can the interpretation and image acquisition be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

Does modifier 50 increase payment for both eyes?

No. Medicare prices 92286 as bilateral, and modifier 50 does not increase payment.

How does the multiple-procedure reduction affect this code?

The ophthalmology diagnostic multiple-procedure reduction applies to the technical component when applicable. It applies to the TC portion, not the professional interpretation under the CMS rule provided.

What should the record support?

Document the clinical reason for endothelial imaging, the images or test results, and an interpretation tied to the patient’s corneal findings or management.

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 92286PPRRVU2026_Oct_nonQPP.csv, line 11,747 (RVU26D)