$16.10–$17.65
Choose 92201 for a retinal drawing; choose 92202 when the documented drawing focuses on the optic nerve or macula.
On this page
CMS RVU26D · Effective 2026-10-01
92201 Extended ophthalmoscopy Medicare reimbursement rates in Washington
Report 92201 for an extended examination of the retina with a documented drawing, interpretation, and report, for one or both eyes. Compare 92201 office and facility rates across CMS payment localities in Washington.
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 92201 in Washington?
Washington 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
$25.66–$28.16
2 of 2 localities have a supported rate.
Facility setting
$18.63–$19.96
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
About 92201: Extended retinal ophthalmoscopy with drawing
Report 92201 for an extended examination of the retina with a documented drawing, interpretation, and report, for one or both eyes.
An ophthalmologist or other qualified eye-care professional performs an extended examination of the retina and records the findings in a retinal drawing. Typical reasons include evaluating or documenting retinal detachment or a retinal melanoma. The service involves more than routine ophthalmoscopy: the record should show the retinal findings examined and include the drawing and the clinician’s interpretation and report.
Select 92201 when the documented drawing concerns the retina; use the related code 92202 when the drawing concerns the optic nerve or macula. The code covers unilateral or bilateral service. CMS prices it as bilateral, so modifier 50 does not increase payment. Documentation should identify the eye or eyes examined, the clinical findings, and the drawing and report supporting the extended examination.
CMS billing rules for 92201
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.39 · 52%
- Practice expense (office) RVU0.34 · 45%
- Malpractice RVU0.02 · 3%
463.5K
Medicare services in 2024 · #239 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.
92201 compared with similar codes
Office rates for Washington, from the same CMS release.
$38.32–$42.91
92201 involves an extended ophthalmoscopic examination with a drawing and report. 92250 describes fundus photography with interpretation and report.
$31.40–$35.19
92228 describes retinal imaging for disease detection or monitoring by a physician or qualified health professional, not an extended ophthalmoscopic examination with a drawing.
Compare 92201 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
Rest Of Washington →
Office / nonfacility
$25.66
Facility
$18.63
Seattle (King Cnty) →
Office / nonfacility
$28.16
Facility
$19.96
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92201 billing questions
How is 92201 different from 92202?
92201 is for an extended examination with a retinal drawing. 92202 is for a drawing of the optic nerve or macula.
Can 92201 be reported for both eyes?
Yes. The code covers unilateral or bilateral service, and CMS prices it as bilateral. Modifier 50 does not increase payment.
What documentation supports 92201?
Document the eye or eyes examined, the retinal findings, and the drawing, interpretation, and report. A routine eye examination without the retinal drawing and report does not describe this service.
Is a retinal photograph the same service as 92201?
No. 92201 describes an extended ophthalmoscopic examination with a retinal drawing and report. Fundus photography, reported with 92250, records the retina photographically.
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.
11,70292145,,Corneal hysteresis deter,A,,0.10,0.29,,0.29,NA,0.02,0.41,0.41,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,70392145,26,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