Summary & Overview
CPT 92273: Electrophysiologic Test of Retinal Function
CPT code 92273 represents an electrophysiologic test of retinal function—commonly performed as full‑field (Ganzfeld) or flash/focal electroretinography—to assess outer or generalized retinal function. This diagnostic ophthalmic procedure is an important objective measure in evaluating retinal disorders such as retinitis pigmentosa, cone‑rod dystrophies, toxic or drug‑induced retinopathies, and unexplained vision loss, and it supports clinical decision‑making and eligibility determinations for certain therapies.
Key payers in this national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for 92273, expected sites of service, and payer coverage landscape. The publication summarizes typical use cases, billing considerations, and common modifiers provided in the input, and flags areas where data was not available.
This overview equips clinicians, billing professionals, and policy analysts with a clear reference to the procedure represented by CPT code 92273, the settings where it is typically performed, and which major public and commercial payers are included in the coverage discussion. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92273 describes an electrophysiologic test of retinal function, commonly performed as conventional, full–field or Ganzfeld (ffERG) or flash/focal (fERG) electroretinography. The procedure assesses outer or generalized retinal function by recording electrical responses of the retina to light stimuli.
Service Type: Diagnostic ophthalmic electrophysiology
Typical Site of Service: Ophthalmology clinic, hospital outpatient department, or specialized eye center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with progressive nyctalopia and decreased peripheral vision is referred to a retinal specialist for electrophysiologic testing. The eye care team schedules a full-field electroretinogram to assess generalized outer retinal function and to differentiate rod-cone dystrophy from optic nerve or cortical causes. On the day of service the patient arrives at an outpatient ophthalmology clinic or ambulatory surgical center. After informed consent, pupils are dilated, corneal electrodes or contact lens electrodes are placed following topical anesthesia, and standardized Ganzfeld flash stimuli are delivered. Responses are recorded, amplified, and interpreted by the physician to guide diagnosis (for example, retinitis pigmentosa, cone-rod dystrophy, toxic retinopathy) and to inform genetic testing, treatment planning, or counseling. Billing uses 92273 for the electrophysiologic test of retinal function (full-field or flash/focal ERG). Typical sites of service include outpatient ophthalmology offices, hospital outpatient departments, and ambulatory surgical centers. Patient flow includes pretest screening for contraindications, electrode placement, recording (generally 20–60 minutes), electrode removal, and documentation of technical parameters and physician interpretation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician interpretation/report separate from the technical component |