CPT 92285
Global XXX ActiveExternal ocular photography
CPT 92285 Billing & Documentation Guide
CPT code 92285 (External ocular photography) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.05, a non-facility practice expense RVU of 0.64, and a malpractice RVU of 0.02, a total non-facility RVU of 0.71 and facility RVU of 0.71. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $24.59, though rates vary from $20.38 to $33.04 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92285, 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 92285 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 92285 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 92285
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.05 | 0.05 |
| Practice Expense RVU | 0.64 | 0.64 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 0.71 | 0.71 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92285
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 | $27.39 | $27.39 | $25.49 - $33.04 | 29 |
| Florida | $24.42 | $24.42 | $23.11 - $25.61 | 3 |
| Georgia | $22.87 | $22.87 | $21.53 - $24.2 | 2 |
| Illinois | $23.61 | $23.61 | $22.23 - $24.82 | 4 |
| Michigan | $22.68 | $22.68 | $21.94 - $23.42 | 2 |
| North Carolina | $22.04 | $22.04 | $22.04 - $22.04 | 1 |
| New York | $26.51 | $26.51 | $22.45 - $28.43 | 5 |
| Ohio | $21.86 | $21.86 | $21.86 - $21.86 | 1 |
| Pennsylvania | $23.34 | $23.34 | $21.93 - $24.75 | 2 |
| Texas | $23.34 | $23.34 | $21.74 - $24.88 | 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 92285
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92285 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 |
| 92020 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 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 |
| 15820 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
| 15821 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
| 15822 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
| 15823 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 92285
What does CPT code 92285 mean? +
CPT code 92285 represents: External ocular photography. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92285? +
The 2026 Medicare national average non-facility payment for CPT 92285 is $24.59. Rates range from $20.38 to $33.04 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92285? +
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 92285? +
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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