CPT 92273
Global XXX ActiveFull field erg w/i&r
CPT 92273 Billing & Documentation Guide
CPT code 92273 (Full field erg w/i&r) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.67, a non-facility practice expense RVU of 2.99, and a malpractice RVU of 0.03, a total non-facility RVU of 3.69 and facility RVU of 3.69. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $127.92, though rates vary from $108.68 to $169.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92273, 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 92273 with related codes; this code has 9 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 92273 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 92273
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.67 | 0.67 |
| Practice Expense RVU | 2.99 | 2.99 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 3.69 | 3.69 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92273
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 | $141.9 | $141.9 | $132.75 - $169.39 | 29 |
| Florida | $124.53 | $124.53 | $119.36 - $128.88 | 3 |
| Georgia | $118.89 | $118.89 | $112.66 - $125.12 | 2 |
| Illinois | $120.87 | $120.87 | $115.12 - $126.88 | 4 |
| Michigan | $117.57 | $117.57 | $114.69 - $120.44 | 2 |
| North Carolina | $116.2 | $116.2 | $116.2 - $116.2 | 1 |
| New York | $136.22 | $136.22 | $117.96 - $144.42 | 5 |
| Ohio | $114.57 | $114.57 | $114.57 - $114.57 | 1 |
| Pennsylvania | $121.47 | $121.47 | $115 - $127.94 | 2 |
| Texas | $121.75 | $121.75 | $114.19 - $128.97 | 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 92273
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92273 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 | Yes | Misuse of Column Two code with Column One code |
| 99446 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99447 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99448 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99449 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92273
What does CPT code 92273 mean? +
CPT code 92273 represents: Full field erg w/i&r. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92273? +
The 2026 Medicare national average non-facility payment for CPT 92273 is $127.92. Rates range from $108.68 to $169.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92273? +
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 92273? +
This code has 9 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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