{
    "code": "92201",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/92201/2023/A",
    "release_specific_url": "https://localishealth.com/cpt/92201/2023/C",
    "description": "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.",
    "answer": {
        "question": "How much did Medicare pay for CPT 92201 in Q3 2023?",
        "text": "Medicare paid $24.74 for CPT 92201 in the office (non-facility) setting and $22.37 in a facility under the Q3 2023 Physician Fee Schedule, effective July 2023. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2023, when it decreased 0.7%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2023,
        "quarter": "C",
        "label": "Q3 2023",
        "effective": "July 1 – September 30, 2023",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 24.74,
        "facility": 22.37,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.4,
        "practice_expense_non_facility": 0.31,
        "practice_expense_facility": 0.24,
        "malpractice": 0.02
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 33.8872,
    "source": {
        "label": "Physician relative value file (Q3 2023)",
        "cms_url": "https://www.cms.gov/files/zip/rvu23c.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2023/C",
        "file": "PPRRVU23_JUL.csv",
        "row": 16723,
        "sha256": "64251eae48773025b05c6e45a77e1909e7151c421fe8f346124ba9623c491e37"
    },
    "modified_at": "2026-08-04T03:12:57+00:00"
}