CPT 92202
Global XXX ActiveOpscpy extnd on/mac draw
CPT 92202 Billing & Documentation Guide
CPT code 92202 (Opscpy extnd on/mac draw) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.25, a non-facility practice expense RVU of 0.21, and a malpractice RVU of 0.01, a total non-facility RVU of 0.47 and facility RVU of 0.35. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $16.13, though rates vary from $14.55 to $20.18 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92202, 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 92202 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 92202 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 92202
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.25 | 0.25 |
| Practice Expense RVU | 0.21 | 0.09 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 0.47 | 0.35 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92202
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 | $17.13 | $12.39 | $16.36 - $19.56 | 29 |
| Florida | $16.04 | $12.02 | $15.56 - $16.5 | 3 |
| Georgia | $15.46 | $11.63 | $15.01 - $15.9 | 2 |
| Illinois | $15.79 | $11.93 | $15.28 - $16.22 | 4 |
| Michigan | $15.41 | $11.64 | $15.13 - $15.68 | 2 |
| North Carolina | $15.11 | $11.37 | $15.11 - $15.11 | 1 |
| New York | $17.02 | $12.55 | $15.25 - $17.84 | 5 |
| Ohio | $15.09 | $11.43 | $15.09 - $15.09 | 1 |
| Pennsylvania | $15.65 | $11.73 | $15.1 - $16.2 | 2 |
| Texas | $15.61 | $11.67 | $15.04 - $16.08 | 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 92202
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92202 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 |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99211 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 99211 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 0465T | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 67005 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 67010 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 67015 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 67025 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 92202
What does CPT code 92202 mean? +
CPT code 92202 represents: Opscpy extnd on/mac draw. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92202? +
The 2026 Medicare national average non-facility payment for CPT 92202 is $16.13. Rates range from $14.55 to $20.18 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92202? +
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 92202? +
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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