CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Ophthalmology
92002 — Ophthalmological services; new patient, intermediate
This is an eye exam for a new patient that involves evaluation of a new or existing condition with a complaint-driven history and examination of relevant structures.
- Typical setting: Eye doctor's office
- National avg charge (illustrative): $75–$175 (intermediate new patient eye exam)
- Most-disputed reason: Billing 92004 (comprehensive) when only an intermediate-level exam was documented — the key distinction is whether a general medical observation and ophthalmic evaluation with initiation of a diagnostic program was performed.
What it means
What 92002 actually means
This is an eye exam for a new patient that involves evaluation of a new or existing condition with a complaint-driven history and examination of relevant structures. It is less comprehensive than a complete new patient exam and covers examination related to a specific complaint.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 92004 (comprehensive) when only an intermediate-level exam was documented — the key distinction is whether a general medical observation and ophthalmic evaluation with initiation of a diagnostic program was performed.
- Confusion between ophthalmology exam codes (92002/92004) and standard E/M office visit codes (99202–99205) — ophthalmologists may use either code set but cannot bill both on the same date.
- Being billed as a 'new patient' when you are an established patient who has been seen within the past 3 years by the same provider or group practice.
If you see 92002 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 92002 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 92002 on a bill.
92002 FAQ
Plain-English answers.
What does 92002 usually cost?
$75–$175 (intermediate new patient eye exam). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 92002?
Billing 92004 (comprehensive) when only an intermediate-level exam was documented — the key distinction is whether a general medical observation and ophthalmic evaluation with initiation of a diagnostic program was performed.
What should I do if I see 92002 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 92002 before paying.
Don't pay 92002 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.