92202 Opscpy extnd on/mac draw
What 92202 is
CMS fee schedule short descriptor: Opscpy extnd on/mac draw.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 92202 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.25 | 0.21 | 0.01 | 0.47 | $15.70 |
| Facility (hospital, ASC) | 0.25 | 0.09 | 0.01 | 0.35 | $11.69 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 92202 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 92202? These codes are bundled into it
92202 is a Column 1 code in 4 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 1 - modifier may bypass | Check pair |
92202 is bundled into these codes
92202 appears as a Column 2 code in 37 active edits. Reported with one of these Column 1 codes on the same date of service, 92202 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
67005 | Partial removal of eye fluid | 1 | Check pair |
67010 | Partial removal of eye fluid | 1 | Check pair |
67015 | Release of eye fluid | 1 | Check pair |
67025 | Replace eye fluid | 1 | Check pair |
67027 | Implant eye drug system | 1 | Check pair |
67028 | Injection eye drug | 1 | Check pair |
67030 | Incise inner eye strands | 1 | Check pair |
67031 | Laser surgery eye strands | 1 | Check pair |
67036 | Removal of inner eye fluid | 1 | Check pair |
67039 | Laser treatment of retina | 1 | Check pair |
67040 | Laser treatment of retina | 1 | Check pair |
67041 | Vit for macular pucker | 1 | Check pair |
67042 | Vit for macular hole | 1 | Check pair |
67043 | Vit for membrane dissect | 1 | Check pair |
67101 | Repair detached retina crtx | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.