Three questions every OD asks before billing for OCTA: Can I bill for this? How much will I get? What do I need to document? This page answers all three — clearly, without the legalese.
CPT 92137 describes: "Computerized ophthalmic diagnostic imaging of the retina, including OCT angiography (OCT-A), with interpretation and report."
This is the dedicated billing code for OCT angiography — the imaging modality that maps retinal vasculature without dye injection, detecting blood flow patterns in specific vascular plexuses. 92137 covers both the acquisition and the physician's interpretation in a single code.
Introduced in 2025, with reimbursement and policy updates taking effect in 2026. It's distinct from standard OCT codes (92133, 92134) because it specifically requires the angiographic component — not just structural OCT.
Plain language: If you run OCTA and write an interpretation report documenting what you found, 92137 is the code. It captures both the scan and your clinical interpretation. The key word is "angiography" — there must be a flow-based component to the imaging.
Note: 92137 includes the structural OCT component, which is why it cannot be billed alongside 92133 or 92134 on the same date of service.
The national average Medicare reimbursement for 92137 is approximately $56.93. That's significantly higher than standard OCT codes — but lower than 2024 rates due to CMS adjustments.
| CPT Code | Description | ~2026 Medicare Rate | vs. 92137 |
|---|---|---|---|
| 92137 | OCT-A (OCTA) with interpretation & report | ~$56.93 | — |
| 92134 | OCT retina with interpretation | ~$31.38 | $25.55 less |
| 92133 | OCT optic nerve with interpretation | ~$29.76 | $27.17 less |
| 92132 | OCT anterior segment | ~$28.79 | $28.14 less |
Important context: 92137 rates declined approximately 22% from 2024 to 2026 as part of CMS rebalancing. Despite the reduction, it remains the highest-paying retinal imaging code in the standard OCT family. Private payer rates vary — some reimburse above Medicare, some below, and coverage policies differ significantly by payer.
MPPR applies. When 92137 is billed with another diagnostic test on the same day, Medicare's Multiple Procedure Payment Reduction reduces the technical component of the lesser-valued test by 20%. Factor this into revenue projections when OCTA is billed alongside other imaging.
You can bill 92137 only when both the OCT and the angiographic (OCTA) components are medically necessary for that specific patient encounter. The key phrase is "medically necessary" — not "available" or "convenient."
Do not bill 92137 for routine OCT imaging. If you're running standard structural OCT (even on equipment that also has OCTA capability), that's 92134. The angiographic component must be clinically indicated, ordered, and interpreted — not just incidentally captured.
This is where most practices run into trouble. 92137 has specific bundling restrictions that differ from standard OCT codes.
OCT optic nerve. Cannot bill 92133 and 92137 on the same date of service.
OCT retina. Cannot bill 92134 and 92137 on the same date of service.
Fluorescein angiography — when clinically justified. FA provides different information than OCTA flow mapping.
ICG angiography or combined FA/ICG — when clinically warranted. Document separate medical necessity for each modality.
The bundling logic: You cannot bill 92137 alongside 92133 or 92134 because 92137 already encompasses OCT-level retinal imaging — you'd be double-billing for overlapping services. Fluorescein and ICG angiography are distinct modalities (dye-based) with separate clinical rationale, so they can be combined when both are genuinely needed.
Billing 92137 without the right documentation is what triggers audits and recoupment. Here's what your chart needs to show for each 92137 encounter:
The interpretation report is more than a line in the chart note. It should include: the clinical indication, a description of significant findings (by vascular layer/plexus), comparison to prior imaging if available, and the clinical conclusion — specifically how the findings informed the diagnosis or treatment decision.
Audit pattern to avoid: "OCTA performed, no significant findings" — this documentation pattern is a red flag. If OCTA was genuinely medically necessary, there should be a finding or a meaningful negative finding documented with clinical context. Blank or minimal interpretation language signals that the test may not have been clinically justified.
Compliant example: "OCTA of macula reveals enlarged FAZ (0.42 mm²) and patchy capillary dropout in the deep capillary plexus, consistent with progression of diabetic macular ischemia. Findings support continued anti-VEGF and closer monitoring."
Beginning with the 2025 introduction of CPT 92137, this code was classified as a designated health service (DHS) under the Stark Law. This classification continues OCTA's existing classification under Stark — when OCTA was billed under 92134, that code was already on the DHS list. The framework didn't appear with 92137; it carried forward.
For most private practice ODs doing in-office OCTA on equipment they own and operating under proper supervision standards: the practical impact is limited. The Stark Law concern is most relevant for practices with shared arrangements, co-location agreements, or referral relationships with hospitals or imaging centers. If that describes you, get a compliance review.
The 2026 update also prompted payer system updates, as many insurance processing systems required time to recognize 92137 as a standalone payable code. Denial management and resubmission workflows are worth building into your billing process.
Is OCTA Worth Adding to Your Practice?
At approximately $56.93 per encounter, 10 medically-justified OCTA studies per week generates roughly $2,465/month from Medicare alone — before private payer rates and before MPPR adjustments when bundled with other diagnostics.
The math is straightforward. The compliance work is not. Practices that succeed with 92137 invest in documentation systems before they invest in patient volume. Practices that get audited usually have it backwards.
Equipment costs, training time, and the per-visit interpretation burden need to factor into the ROI calculation. This page covers the billing side. The clinical interpretation skills are covered in SlabED's OCTA curriculum.
Modern OCTA equipment often captures angiographic data automatically — even when the scan was ordered as a standard OCT. This creates a significant compliance risk if billing follows the capture rather than the clinical indication.
The rule: Billing is determined by what you ordered and what you interpreted — not by what the equipment captured. If the scan was ordered as 92134 and you only reviewed the structural OCT, you bill 92134. Even if OCTA data was automatically recorded, billing 92137 without the clinical indication and interpretation is a compliance violation.
Audit risk is manageable with the right documentation system. The practices that get into trouble are the ones who treat 92137 as a blanket upgrade to their standard OCT billing rather than a distinct, medically-justified service.
Bottom line on compliance: If you can answer "yes" to these three questions before billing 92137, you're in good shape: (1) Was OCTA specifically indicated for this patient at this visit? (2) Was it ordered? (3) Is there a signed interpretation report documenting findings and their clinical significance?
Before you can bill for OCTA, you need to read it. SlabED's Tier 3 teaches OCTA interpretation, four-modality analysis, and the clinical findings that justify 92137 billing.
SlabED is the only OCT education platform that teaches practice economics and CPT billing alongside the clinical curriculum. See how we compare to alternatives.