What is the standard insurance baseline for CPT 92240?

The standard insurance baseline reimbursement rate is $185.09. This represents the customary allowable amount established across standard fee schedules.

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CPT 92240Medical Service

Exam of Blood Vessels Between the White Part of Eye and Retina using a Special Camera After Injection of a Dye

Q: What do doctors typically charge for Exam of Blood Vessels Between the White Part of Eye and Retina using a Special Camera After Injection of a Dye?

The nationwide median physician charge for Exam of Blood Vessels Between the White Part of Eye and Retina using a Special Camera After Injection of a Dye (CPT 92240) is $467.85. Doctor billed charges vary based on geographic region, setting, and overhead.

Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye. Clinical pricing breakdown and utilization metrics across 39 practicing doctors nationwide.

$467.85

Peer Median Charge

Gross billed rate

$185.09

Standard Baseline

Customary allowable

2.5x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $467.85. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $185.09 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 92240 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"