CPT 92240
Global XXX ActiveIcg angiography i&r uni/bi
CPT 92240 Billing & Documentation Guide
CPT code 92240 (Icg angiography i&r uni/bi) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.78, a non-facility practice expense RVU of 6.49, and a malpractice RVU of 0.08, a total non-facility RVU of 7.35 and facility RVU of 7.35. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $255.1, though rates vary from $213.64 to $342.94 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92240, 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 92240 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 92240 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 92240
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.78 | 0.78 |
| Practice Expense RVU | 6.49 | 6.49 |
| Malpractice RVU | 0.08 | 0.08 |
| Total RVU | 7.35 | 7.35 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92240
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 | $284.94 | $284.94 | $265.51 - $342.94 | 29 |
| Florida | $248.75 | $248.75 | $237.3 - $258.47 | 3 |
| Georgia | $236.09 | $236.09 | $222.6 - $249.58 | 2 |
| Illinois | $240.7 | $240.7 | $228.14 - $253.59 | 4 |
| Michigan | $233.36 | $233.36 | $226.98 - $239.74 | 2 |
| North Carolina | $230.01 | $230.01 | $230.01 - $230.01 | 1 |
| New York | $272.75 | $272.75 | $233.86 - $290.42 | 5 |
| Ohio | $226.66 | $226.66 | $226.66 - $226.66 | 1 |
| Pennsylvania | $241.47 | $241.47 | $227.57 - $255.37 | 2 |
| Texas | $242.09 | $242.09 | $225.8 - $257.82 | 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 92240
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92240 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 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 |
| 90760 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 92240
What does CPT code 92240 mean? +
CPT code 92240 represents: Icg angiography i&r uni/bi. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92240? +
The 2026 Medicare national average non-facility payment for CPT 92240 is $255.1. Rates range from $213.64 to $342.94 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92240? +
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 92240? +
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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