# CPT 92201

> Medicare paid $25.12 for CPT 92201 in the office (non-facility) setting and $23.03 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 2.0% decrease from the previous quarter.

## What it is

A detailed examination of the far edges of the retina, well beyond what a standard dilated look covers, documented with a labeled drawing of the findings. The doctor uses an indirect ophthalmoscope and typically presses gently on the outside of the eye to roll the peripheral retina into view, then records the location and extent of tears, thinning, detachment, or other lesions. The drawing serves as a baseline that later exams are compared against. A companion code covers the same kind of extended exam and drawing focused instead on the optic nerve and the central retina.

## Selected release

- Release: Q1 2021 (2021 A)
- Effective: January 1 – March 31, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $25.12
- Facility national allowed amount: $23.03
- Sequestration: not applied

## RVUs and formula

- Work RVU: 0.40
- Office (non-facility) practice expense RVU: 0.30
- Facility practice expense RVU: 0.24
- Malpractice RVU: 0.02
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip
- Parsed file: PPRRVU21_JAN.csv, row 15,907
- Canonical page: https://localishealth.com/cpt/92201/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/92201/2021/A
- Last significant update: 2026-08-04T03:10:16+00:00