CPT 92265
Global XXX ActiveNdl oculoelectromyography 1+
CPT 92265 Billing & Documentation Guide
CPT code 92265 (Ndl oculoelectromyography 1+) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.79, a non-facility practice expense RVU of 1.83, and a malpractice RVU of 0.02, a total non-facility RVU of 2.64 and facility RVU of 2.64. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $91.29, though rates vary from $79.24 to $117.79 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92265, 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 92265 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 92265 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 92265
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.79 | 0.79 |
| Practice Expense RVU | 1.83 | 1.83 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 2.64 | 2.64 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92265
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 | $100.02 | $100.02 | $94.18 - $117.79 | 29 |
| Florida | $89.01 | $89.01 | $85.82 - $91.71 | 3 |
| Georgia | $85.54 | $85.54 | $81.71 - $89.37 | 2 |
| Illinois | $86.82 | $86.82 | $83.24 - $90.53 | 4 |
| Michigan | $84.73 | $84.73 | $82.95 - $86.5 | 2 |
| North Carolina | $83.84 | $83.84 | $83.84 - $83.84 | 1 |
| New York | $96.73 | $96.73 | $84.92 - $101.99 | 5 |
| Ohio | $82.87 | $82.87 | $82.87 - $82.87 | 1 |
| Pennsylvania | $87.21 | $87.21 | $83.13 - $91.29 | 2 |
| Texas | $87.33 | $87.33 | $82.63 - $91.7 | 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 92265
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92265 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 |
| 92531 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 92532 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 92533 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 92534 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 92537 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 92538 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 92540 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 92541 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 92265
What does CPT code 92265 mean? +
CPT code 92265 represents: Ndl oculoelectromyography 1+. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92265? +
The 2026 Medicare national average non-facility payment for CPT 92265 is $91.29. Rates range from $79.24 to $117.79 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92265? +
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 92265? +
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 June 1, 2026.
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