92228 Img rta detc/mntr ds phy/qhp
What 92228 is
CMS fee schedule short descriptor: Img rta detc/mntr ds phy/qhp.
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 92228 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.31 | 0.58 | 0.02 | 0.91 | $30.39 |
| Facility (hospital, ASC) | 0.31 | 0.58 | 0.02 | 0.91 | $30.39 |
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 92228 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 92228? These codes are bundled into it
92228 is a Column 1 code in 11 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 | |
|---|---|---|---|
0604T | Rem oct rta dev setup&educaj | 0 - no modifier bypass | Check pair |
0605T | Rem oct rta techl sprt min 8 | 0 - no modifier bypass | Check pair |
0606T | Rem oct rta phys/qhp ea 30d | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
92133 | Cptrzd oph dx img pst sgm on | 0 - no modifier bypass | Check pair |
92134 | Cptrz oph dx img pst sgm rta | 0 - no modifier bypass | Check pair |
92227 | Img rta detcj/mntr ds staff | 0 - no modifier bypass | Check pair |
92229 | Img rta detc/mntr ds poc aly | 0 - no modifier bypass | Check pair |
92250 | Fundus photography w/i&r | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
92228 is bundled into these codes
92228 appears as a Column 2 code in 51 active edits. Reported with one of these Column 1 codes on the same date of service, 92228 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
92002 | Intrm oph exam new patient | 0 | Check pair |
92004 | Compre oph exam new pt 1/> | 0 | Check pair |
92012 | Intrm oph exam est patient | 0 | Check pair |
92014 | Compre oph exam est pt 1/> | 0 | Check pair |
92137 | Cptrz oph img pst sg rta oct | 0 | Check pair |
99202 | Office o/p new sf 15 min | 1 | Check pair |
99203 | Office o/p new low 30 min | 1 | Check pair |
99204 | Office o/p new mod 45 min | 1 | Check pair |
99205 | Office o/p new hi 60 min | 1 | Check pair |
99211 | Off/op est may x req phy/qhp | 1 | Check pair |
99212 | Office o/p est sf 10 min | 1 | Check pair |
99213 | Office o/p est low 20 min | 1 | Check pair |
99214 | Office o/p est mod 30 min | 1 | Check pair |
99215 | Office o/p est hi 40 min | 1 | Check pair |
99221 | 1st hosp ip/obs sf/low 40 | 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.