{
    "code": "92250",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/92250/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/92250/2019/A",
    "description": "Photographs of the back of the eye, capturing the retina, optic nerve, and blood vessels, together with the clinician's interpretation and written report. The pupils are often dilated first, and the camera flashes once per eye; no dye is injected, which is what separates this from angiography. The images provide a permanent record that later photographs can be compared against, making slow change visible in a way that memory and notes cannot. The report on the findings is part of the service, not an extra.",
    "answer": {
        "question": "How much did Medicare pay for CPT 92250 in Q1 2019?",
        "text": "Medicare paid $51.54 for CPT 92250 in the office (non-facility) setting and $51.54 in a facility under the Q1 2019 Physician Fee Schedule, effective January 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 11.6% decrease from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "A",
        "label": "Q1 2019",
        "effective": "January 1 – March 31, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 51.54,
        "facility": 51.54,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.4,
        "practice_expense_non_facility": 1.01,
        "practice_expense_facility": 1.01,
        "malpractice": 0.02
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q1 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/A",
        "file": "PPRRVU19_V1213.csv",
        "row": 15583,
        "sha256": "027b1b615e25a1c68ccff88175acf40056bc59d858295f8e37b0c5a88a2e7d35"
    },
    "modified_at": "2026-08-04T03:08:45+00:00"
}