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Medicare National Unadjusted Base Rates

2010 Final Rule – Effective Jan 1, 2010 – Feb 28, 2010

Code Description Unilateral/
Bilateral
Same Day
Restriction
National Unadjusted Base Rates
92135 Scanning Laser (HRT or OCT) Unilateral No 92250* $44.02 Per Eye
92235 Fluorescein Angiography Unilateral $119.08 Per Eye
92240 Indocyanine Green Unilateral No 92250* $219.39 Per Eye
92250 Fundus photography Bilateral No 92135* $67.48
92285 External Ocular Photography Bilateral $39.69
92286 Ant. Segment Photography (cell count) Bilateral $110.78
92287 Ant. Segment Fluorescein Angiography Bilateral $106.81

* Correct Coding Initiative (CCI) rules prohibit billing of these codes on the same day.

CPT and all CPT codes are copyrighted by the American Medical Association with all rights and privileges reserved. This document should not be considered a replacement for published Medicare regulations.

Unilateral Code = The reimbursement amount is for one eye; if it is medically appropriate to treat/evaluate both eyes reimbursement would be twice this amount.

Bilateral Code = The reimbursement amount for both eyes; if only one is treated/evaluated reimbursement should be 1/2 of this amount.

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