92072 Fitting contact lens for management of $ 104.54 $80.01 keratoconus initial fitting 92081 Visual field exam(s) limited $ 33.37 $ 33.37 92082 Visual field exam(s) Intermediate $ 49.38 $ 49.38 92083 Visual field exam(s) extended $ 56.74 $ 56.74 92100 Serial Tonometry exam(s) $ 63.33 $34.29 92132 Scanning Computerized ophthalmic $ 30.41 $ 30.41 diagnostic imaging anterior segment, with interpretation and report 92133 Scanning Computerized ophthalmic $ 37.09 $ 37.09 diagnostic imaging posterior segment, with interpretation and report unilateral or bilateral; optic nerve 92134 Scanning Computerized ophthalmic $ 37.09 $ 37.09 diagnostic imaging posterior segment, with interpretation and report unilateral or bilateral; retina 92140 Glaucoma provaction tests w/o $ 40.68 $18.79 tonography 92225 Ophthamoscopy, initial $ 20.98 $16.70 92226 Ophthamoscopy, subsequent $ 19.36 $14.80 92250 Fundus photography w/ interpretation $ 53.55 $ 53.55 and report 92260 Ophthalmodynamoetry $ 14.48 $8.49 92283 Color vision examination extended, e.g., $ 44.78 $ 44.78 anomaloscope or equivalent 92284 Dark adaptation examination w/ $ 51.16 $ 51.16 interpretation and report 92285 External ocular photography w/ $ 30.13 $ 30.13 interpretation and report for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography,
92072 Fitting contact lens for management of keratoconus initial fitting $ 104.54 $80.01 92081 Visual field exam(s) limited $ 33.37 $ 33.37 92082 Visual field exam(s) Intermediate $ 49.38 $ 49.38 92083 Visual field exam(s) extended $ 56.74 $ 56.74 92100 Serial Tonometry exam(s) $ 63.33 $34.29 92132 Scanning Computerized ophthalmic diagnostic imaging anterior segment, with interpretation and report $ 30.41 $ 30.41 92133 Scanning Computerized ophthalmic diagnostic imaging posterior segment, with interpretation and report unilateral or bilateral; optic nerve $ 37.09 $ 37.09 92134 Scanning Computerized ophthalmic diagnostic imaging posterior segment, with interpretation and report unilateral or bilateral; retina $ 37.09 $ 37.09 92140 Glaucoma provaction tests w/o tonography $ 40.68 $18.79 92225 Ophthamoscopy, initial $ 20.98 $16.70 92226 Ophthamoscopy, subsequent $ 19.36 $14.80 92250 Fundus photography w/ interpretation and report $ 53.55 $ 53.55 92260 Ophthalmodynamoetry $ 14.48 $8.49 92283 Color vision examination extended, e.g., anomaloscope or equivalent $ 44.78 $ 44.78 92284 Dark adaptation examination w/ interpretation and report $ 51.16 $ 51.16 92285 External ocular photography w/ interpretation and report for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography, $ 30.13 $ 30.13
EPSD-NEW-MANUAL-FINAL-01-12-17.docx