{
    "code": "92202",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/92202/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/92202/2021/C",
    "description": "A detailed examination of the optic nerve head and the central retina, documented with a labeled drawing of what was seen. It goes well past the retinal check included in a routine dilated exam: the clinician studies the shape, color, cupping and rim of the optic nerve, or the detail of the macula, and records the findings in a diagram that later visits are measured against. The paired code in this family covers the same style of extended exam and drawing aimed at the far periphery of the retina instead. The drawing is the point, since it captures change over time that a written note would blur.",
    "answer": {
        "question": "How much did Medicare pay for CPT 92202 in Q3 2021?",
        "text": "Medicare paid $16.05 for CPT 92202 in the office (non-facility) setting and $14.66 in a facility under the Q3 2021 Physician Fee Schedule, effective July 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it decreased 1.2%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "C",
        "label": "Q3 2021",
        "effective": "July 1 – September 30, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 16.05,
        "facility": 14.66,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.26,
        "practice_expense_non_facility": 0.19,
        "practice_expense_facility": 0.15,
        "malpractice": 0.01
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q3 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21c-updated-6302021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/C",
        "file": "PPRRVU21_JUL.csv",
        "row": 15984,
        "sha256": "ee14b5306942acfe4554d2d7cf3fe95d7b1a0f41fc7a0445bc2d06df857dd7b6"
    },
    "modified_at": "2026-08-04T03:10:45+00:00"
}