CPT 92201

Across 452,704 services billed by 2,484 providers to 325,979 beneficiaries, Medicare allowed an average of $25.70 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

• 92250Photography of the retina$35.91
• 92202Extended exam of the back part of the eye$15.95
• 92285Photography of content of eyes$21.67
• 92235Exam of retinal blood vessels$162.79
• 92273Measurement of retinal and optic nerve function$122.61
• 92286Imaging of front third of eye$38.45
• 92283Extended exam involving color vision testing$49.33
• 92284Evaluation of eye adaptation to light and dark$34.27
• 92242Exam of retinal blood vessels and blood vessels between the white part$289.54
• 92228Imaging of retina$23.67
• 92240Exam of blood vessels between the white part of eye and retina$181.64
• 92287Imaging of front third of eye$154.40

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

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