$160.63
92235 uses fluorescein imaging to assess retinal vascular findings; 92260 measures retinal arterial pressure through controlled pressure on the eye.
On this page
CMS RVU26D · Effective 2026-10-01
92260 Ophthalmic test Medicare reimbursement rates in Vermont
Report ophthalmodynamometry when an ophthalmic clinician measures retinal arterial pressure using controlled pressure applied to the eye. Compare 92260 office and facility rates across CMS payment localities in Vermont.
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 92260 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$18.42
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$8.83
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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 92260: Retinal artery pressure measurement
Report ophthalmodynamometry when an ophthalmic clinician measures retinal arterial pressure using controlled pressure applied to the eye.
Ophthalmodynamometry uses a specialized instrument to apply controlled pressure to the eye while the clinician observes retinal artery pulsation and estimates retinal arterial pressure. An ophthalmologist or other qualified eye-care professional may perform the test during an ophthalmic evaluation when retinal circulation or suspected carotid occlusive disease is being assessed. It is a pressure measurement, not retinal photography or dye-based imaging.
Report 92260 for the documented pressure-measurement service. The record should support why the test was performed and identify the findings or interpretation; an image or general retinal examination alone does not establish that ophthalmodynamometry occurred. CMS prices the code as bilateral, so report it once for the service and do not expect modifier 50 to increase payment.
CMS billing rules for 92260
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.20 · 36%
- Practice expense (office) RVU0.35 · 62%
- Malpractice RVU0.01 · 2%
3.5K
Medicare services in 2024 · #2071 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.
92260 compared with similar codes
Office rates for Vermont, from the same CMS release.
$36.51
92250 documents the fundus photographically. It does not measure retinal arterial pressure as 92260 does.
$185.80
93880 is a bilateral extracranial carotid duplex study. Choose it for ultrasound evaluation of carotid arteries, not for ophthalmodynamometry.
Compare 92260 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.
1 of 1 payment localities
Vermont →
Office / nonfacility
$18.42
Facility
$8.83
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92260 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
11,725
- Code
- 92260
- Physician work
- 0.20
- Practice expense
- 0.35
- Malpractice
- 0.01
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.20 | × 1.000 | 0.2000 |
| Practice expense | 0.35 | × 0.990 | 0.3465 |
| Malpractice | 0.01 | × 0.506 | 0.0051 |
| Total RVUs | 0.5516 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$18.42
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.2 | 1 |
| Practice expense | 0.35 | 0.99 |
| Malpractice | 0.01 | 0.506 |
(0.2 × 1 + 0.35 × 0.99 + 0.01 × 0.506) × $33.4009 = $18.42
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.2 | 1 |
| Practice expense | 0.06 | 0.99 |
| Malpractice | 0.01 | 0.506 |
(0.2 × 1 + 0.06 × 0.99 + 0.01 × 0.506) × $33.4009 = $8.83
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
92260 billing questions
When should 92260 be selected instead of retinal imaging?
Use 92260 when the clinician measures retinal arterial pressure with an ophthalmodynamometer. Fundus photography and fluorescein angiography document different findings and do not substitute for that pressure measurement.
Should modifier 50 be appended?
CMS prices 92260 as bilateral. Modifier 50 does not increase payment.
What documentation supports reporting the service?
Document the clinical reason for assessing retinal arterial pressure, performance of the pressure measurement, and the resulting findings or interpretation.
Can retinal photographs be reported as 92260?
No. 92260 represents pressure measurement; retinal photographs are a separate imaging service when performed and supported.
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.
11,72292250,,Fundus photography w/i&r,A,,0.39,0.70,,0.70,NA,0.02,1.11,1.11,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,4.20,4.20,0.09
11,72392250,26,Fundus photography w/i&r,A,,0.39,0.21,,0.21,,0.01,0.61,0.61,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72492250,TC,Fundus photography w/i&r,A,,0.00,0.49,,0.49,NA,0.01,0.50,0.50,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,3.99,3.99,0.08
11,72592260,,Ophthalmodynamometry,A,,0.20,0.35,,0.06,,0.01,0.56,0.27,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72692265,,Ndl oculoelectromyography 1+,A,,0.79,1.83,,1.83,NA,0.02,2.64,2.64,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72792265,26,Ndl oculoelectromyography 1+,A,,0.79,0.55,,0.55,,0.01,1.35,1.35,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,72892265,TC,Ndl oculoelectromyography 1+,A,,0.00,1.28,,1.28,NA,0.01,1.29,1.29,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817