CPT 92137
Global XXX ActiveCptrz oph img pst sg rta oct
CPT 92137 Billing & Documentation Guide
CPT code 92137 (Cptrz oph img pst sg rta oct) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.62, a non-facility practice expense RVU of 1.15, and a malpractice RVU of 0.02, a total non-facility RVU of 1.79 and facility RVU of 1.79. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $61.79, though rates vary from $54.05 to $78.73 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92137, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92137 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 92137 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92137
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.62 | 0.62 |
| Practice Expense RVU | 1.15 | 1.15 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 1.79 | 1.79 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92137
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $67.26 | $67.26 | $63.52 - $78.73 | 29 |
| Florida | $60.55 | $60.55 | $58.43 - $62.38 | 3 |
| Georgia | $58.19 | $58.19 | $55.77 - $60.6 | 2 |
| Illinois | $59.17 | $59.17 | $56.82 - $61.49 | 4 |
| Michigan | $57.72 | $57.72 | $56.53 - $58.9 | 2 |
| North Carolina | $56.97 | $56.97 | $56.97 - $56.97 | 1 |
| New York | $65.45 | $65.45 | $57.67 - $68.95 | 5 |
| Ohio | $56.45 | $56.45 | $56.45 - $56.45 | 1 |
| Pennsylvania | $59.23 | $59.23 | $56.6 - $61.86 | 2 |
| Texas | $59.26 | $59.26 | $56.28 - $61.98 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92137
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92137 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 70030 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76510 | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 76511 | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 76512 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76514 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76529 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 92025 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 92132 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92137
What does CPT code 92137 mean? +
CPT code 92137 represents: Cptrz oph img pst sg rta oct. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92137? +
The 2026 Medicare national average non-facility payment for CPT 92137 is $61.79. Rates range from $54.05 to $78.73 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92137? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92137? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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