Fee Schedule

UEC Fee Schedule 2022
Effective: 8/22/22
Examination, Treatment and Procedures
Procedure Code Fee (in US dollars)Description
0207T175Lipiflow Treatment (per eye)
64612250Destroy nerve, face muscle
65205125Foreign Body Removal, Conjunctival, Superficial
65210125Foreign Body Removal, Conjunctival, Embedded
65222125Foreign Body Removal, Corneal, Slit Lamp
65430500Corneal Scraping, Diagnostic, Smear or Culture
65600650Stromal Puncture
657781900Prokera (Amniotic Membrane)
65855700Trabeculoplasty By Laser
66761700Iridotomy/Iridectomy, By Laser
66821700Laser Surgery, Lens (YAG)
66984 55 (modifier 55 for comanagement)200Comanagement of Post-Op Portion of Extracapsular Cataract Removal With Insertion of IOL
67028200Injection Eye Drug
67105750Retina or Choroid Repair, Photocoagulation
67145750Retina or Choroid Prophylaxis, Photocoagulation
67210750Retina or Choroid Destruction, Localized Lesion, Photocoagulation
67228750Retina or Choroid Destruction, Treatment of Extensive Retinopathy, Photocoagulation
67515150Injection of Medication or Other Substance Into Tenons Capsule
67800275Excision of Chalazion, Single
67805500Excision of Chalazion, Multiple, Different Lids
67820100Correction of Trichiasis, Epilation, Forceps
67825250Correction of trichiasis; epilation, by methods other than forceps (e.g., electrosurgery)
67840650Excision of Lesion of Eyelid (Except Chalzaion) Without Closure or With Simple Direct Closure
68761250Closure of Lacrimal Punctum by Plug
68801175Dilation of Lacrimal Punctum, With or Without Irrigation
68840175Probing of Lacrimal Canaliculi, With or Without Irrigation
76510250Ophthalmic Ultrasound, Diagnostic, B-scan and Quantitative A-scan Performed During Same Patient Encounter
76511165Ophthalmic Ultrasound, Quantitative A-scan Only
76512165Ophthalmic Ultrasound, B-scan, With or Without Non-quantitative A-scan
76513175Anterior Segment Ultrasound, Immersion B-scan or High Resolution Biomicroscopy
7651450Corneal Pachymetry, Unilateral or Bilateral
76519130Ophthalmic Biometry by Ultrasound, A-scan, With IOP Power Calculation
8351640Immunoassay for Other Than Infectious Agent (InflammaDry)
8386140Tear Osmolarity Testing
90791400Psychiatric Diagnostic Evaluation (Intake Interview)
92000300Perceptual Evaluation
92000HT200Perceptual Eval/Skills
92002120Ophthalmological Services, Intermediate, New Patient
92004180Ophthalmological Services, Comprehensive, New Patient
92012110Ophthalmological Services, Intermediate, Established Patient
92014155Ophthalmological Services, Comprehensive, Established Patient
9201555Determination of Refractive State
92015-22150Determination of Refractive State - Complex
92025125Computerized Corneal Topography
9206090Sensorimotor Examination
9206585Orthoptic Training
9208180Visual Field Examination, Limited
92082105Visual Field Examination, Intermediate
92083145Visual Field Examination, Extended
92100125Serial Tonometry
92132105Scanning Computerized Ophthalmic Diagnostic Imaging, Anterior Segment
92133105Scanning Computerized Ophthalmic Diagnostic Imaging, Posterior Segment, Optic Nerve
92134105Scanning Computerized Ophthalmic Diagnostic Imaging, Posterior Segment, Retina
92136170Ophthalmic Biometry by Partial Coherence Interferometry With IOL Power Calculation
9214540Corneal Hysteresis Determination, By Air Impulse Stimulation
9220140Ophthalmoscopy, Extended, Initial
9220235Ophthalmoscopy, Extended, Subsequent
92235175Fluorescein Angiography
92250190Fundus Photography
92273250Electroretinography - Full Field
92274150Electroretinography - Multifocal
(0509T)150Electroretinography - Pattern
92283225Color Vision Eximination, Extended
9228585 External Ocular Photography
92286100Anterior Segment Imaging, With Specular Microscopy
95930210Visually Evoked Potential (VEP)
96132250Neuropsychological Testing Evaluation Services by Physician or Other Qualified Health Care Professional, Including Integration of Patient Data, Interpretation of Standardized Test Results and Clinical Data, Clinical Decision Making, Treatment Planning and Report, and Interactive Feedback to the Patient, Family Member(s) or Caregiver(s), When Performed, First Hour
96133175Neuropsychological Testing Evaluation Services, Each Additional Hour (Add on Code)
99075500* 250**Medical Testimony *Initial, Up to Two Hours **Each Additional Hour
9920165Office Visit, New Patient
9920295Office Visit, New Patient
99203140Office Visit, New Patient
99204200Office Visit, New Patient
99205265Office Visit, New Patient
9921140Office Visit, Established Patient
9921270Office Visit, Established Patient
99213110Office Visit, Established Patient
99214155Office Visit, Established Patient
99215215Office Visit, Established Patient
9924180Office Consultation , New or Established Patient
99242125Office Consultation , New or Established Patient
99243160Office Consultation , New or Established Patient
99244215Office Consultation , New or Established Patient
99245280Office Consultation , New or Established Patient
99EHV100External Home Visit
J9035100Bevacizumab injection
J05858Botulinum toxin (1unit)
J0178950Eylea (1mg)
VU99203140Vuity Initial Visit
VU99213110Vuity Established Patient Visit
VU9921270Vuity Recheck
Contact Lens Services and Materials
Procedure Code Fee (in dollars)Description
92071175Fitting of Contact Lens for Treatment of Ocular Service Disease (bandage contact lens)
92072700Fitting of Contact Lens for Management of Keratoconus, Initial, Bilateral
92310-52350Degenerative Myopia Intial Fit (bilateral)
92310700Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, Medically Necessary, Both Eyes (except aphakia)
92311375Fitting of Medically Necessary Contact Lens, Aphakia, 1 Eye
92312500Fitting of Medically Necessary Contact Lens, Aphakia, Aphakia, Both Eyes
92313350Fitting of Medically Necessary Contact Lens, Corneoscleral Lens, 1 Eye
V2513Starting at 150 per lensContact Lens, Rigid Gas Permeable
V2521Starting at 45 per boxSoft Lenses: Toric
V2522Starting at 50 per boxSoft Lenses: Multifocal
V2523Starting at 40 per boxSoft Lenses: Spherical
V2599Starting at $325 per lensContact Lens, Orthokeratology
V2531Starting at 575 per lensScleral Lens
V26232400Prosthetic Eye, Plastic, Custom, Per Eye
V2625500Enlargement Of Ocular Prosthesis
V2626500Reduction/Ocular Prosthesis
V26272000Sclera Cover Shell
CL12600Cosmetic Rigid Gas Permeable Contact Lens Professional Fee: Scleral/Hybrid
CL14550Orthokeratology- Refit Not Including Lenses
CL1575Intermediate Contact Lens/Eye Health Assessment- Elective Wearer
CL10175Annual Soft Contact Lens Evaluation During Comprehensive Examination
CL102100Annual GP Contact Lens Evaluation During Comprehensive Examination
CL103150Cosmetic Contact Lens Professional Fee: Soft Refit Existing Wearer Same Lens Design in Toric or Multifocal /Rigid Gas Permeable Refit, Change in Power Only
CL104150Cosmetic Soft Contact Lens Professional Fee: Standard Fit
CL105200Cosmetic Soft Contact Lens Professional Fee: Premium Fit
CL106250Cosmetic Rigid Gas Permeable Contact Lens Professional Fee
CL1081350Orthokeratology - Initial Fit Not Including Lenses
CLKIT25Scleral Lens Kit
CLDMV15Scleral Lens Insertion and Removal Plungers
Vision Rehabilitation Materials
Code Fee
(in dollars)
VTKIT65Vision Skills Kit
STAMK75Strabismus Kit
ED101450Educational/Achievment Testing
Optical Materials
Code Fee (in dollars)Description
V2020start at 69Frames
V210069 per pairSV, sph, plano to +/-4.00
V210369 per pairSV, spherocyl, plano to +/-4.00 up to 2.00 D cyl
V220095 per pairBifocal, sph, plano to +/-4.00
V220395 per pairBifocal, spherocyl, plano to +/-4.00 up to 2.00D cyl
V221935 additional per pairSeg over 28mm
V222030 additional per pairBifocal add +3.25 to +4.00
V2300169 per pairTrifocal, sph, plano to +/-4.00
V2303169 per pairTrifocal, spherocyl, plano to +/-4.00 up to 2.00 cyl
V231935 additional per pairTrifocal seg over 28mm
V232035 additional per pairTrifocal add over +3.25 to +4.00
V271515Prism per diopter per eye
V2744110 per pairTint, plastic photochromatic
V274525 per pairTint, anything except photochromatic
V2750Range from 80 to 175 per pairA/R coating
V275530 per pairU-V coating
V276025 per pairS-R coating
V2762150 per pairPolarization
V2781Starting at 160 additional per pair over fee for bifocalsProgressive
V2783Starting at 80 additional per pair over fee for standard lensesHigh Index
V278450 additionalPolycarb
Kids Packages Rx range = +/- 4.00 with -2.00 cyl99, 149, 189, 249Frame and SV polycarbonate lenses
Sports Glasses Rx range = +/- 4.00 with -2.00 cyl199Select Liberty Sports Goggles and SV clear polycarbonate lenses
Procedure CodeFee (in dollars)Description
99212100Telehealth - Office Visit, Established Patient
99213130Telehealth - Office Visit, Established Patient
99202120Telehealth - Office Visit, New Patient
99441100Phone, Eval & Management 5-10 Min
99442130Phone, Eval & Management 11-20 Min
99443160Phone, Eval & Management 21-30 Min
G201225Brief Check-in (5-10 minutes)
G201020Remote Image Review
9945335RPM - Training
9945490RPM - Loaned Device
9945790RPM - Analysis and Discussion
Myopia Managment
Procedure Code Fee (in US dollars)Description
MC0150Initial Consultation Visit
MC02300Baseleine Evaluation
MC03250Annual Evaluation
CL20300Myopia Control Soft Multifocal CL Fit
CL211350Myopia Control Orthokeratology CL Fit Not Including Lenses
CL2275CL Assessment with Annual Myopia Control Visit
CL23200Myopia Control Soft Multifocal CL Refit
CL24550Myopia Control Orthokeratology CL Refit Not Including Lenses