CPT code 92072: Contact lens fitting, keratoconus, initial2026 Medicare rate & RVUs
An initial specialty contact lens fitting for keratoconus, reported when an eye-care clinician selects and evaluates a lens to manage corneal irregularity.
Medicare pays $120.24 for 92072 nationally in the office and $76.49 in a hospital or facility. Local office rates run $112.22–$155.78.
Medicare rate · 92072
Contact lens fitting, keratoconus, initial
- Work RVUs
- 1.92
- Total RVUs
- 3.60
- Global days
- XXX
National rate · 2026
$120.24
Office setting, before claim adjustments.
See every locality for 92072 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 92072 covers
Ophthalmologists and optometrists use this service to fit a contact lens for a patient with keratoconus, whose irregular corneal shape can limit vision with spectacles. The clinician evaluates lens position, movement, vision, and fit; rigid gas-permeable and scleral lenses are common options. The service may take place in an ophthalmology or optometry office where the clinician can assess the cornea and evaluate the lens on the eye.
Report 92072 for the initial fitting specifically for keratoconus, rather than a general contact lens fitting or a therapeutic lens fitting for an ocular-surface condition. Documentation should identify keratoconus and support the fitting work, including the lens fit and clinical assessment. CMS prices this code as bilateral, so modifier 50 does not increase payment. The CMS bilateral pricing applies whether the fitting involves one eye or both.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 92072 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$112.22 to $155.78
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $113.13 | $74.84 |
| Alaska | $155.78 | $109.18 |
| Arizona | $118.47 | $76.07 |
| Arkansas | $112.22 | $74.63 |
| Atlanta, GA | $121.40 | $76.94 |
| Austin, TX | $123.57 | $77.28 |
| Bakersfield, CA | $126.69 | $78.73 |
| Baltimore area, MD | $125.42 | $78.47 |
| Beaumont, TX | $115.20 | $75.38 |
| Brazoria, TX | $120.18 | $76.82 |
| Chicago, IL | $121.40 | $77.43 |
| Chico, CA | $126.53 | $78.58 |
| Colorado | $124.51 | $77.95 |
| Connecticut | $125.89 | $78.77 |
| Dallas, TX | $120.55 | $76.97 |
| Delaware | $119.86 | $76.63 |
| Detroit, MI | $118.52 | $76.30 |
| East St. Louis, IL | $116.12 | $75.86 |
| El Centro, CA | $126.53 | $78.58 |
| Fort Lauderdale, FL | $121.24 | $76.91 |
| Fort Worth, TX | $120.00 | $76.85 |
| Fresno, CA | $126.53 | $78.58 |
| Galveston, TX | $120.31 | $76.86 |
| Hanford, CA | $126.53 | $78.58 |
| Hawaii, Guam, HI | $127.74 | $77.99 |
| Houston, TX | $120.49 | $77.04 |
| Idaho | $115.60 | $75.35 |
| Indiana | $116.00 | $75.44 |
| Iowa | $115.30 | $75.26 |
| Kansas | $114.72 | $75.17 |
| Kentucky | $114.02 | $75.12 |
| King County, WA | $136.05 | $82.36 |
| Los Angeles, CA | $132.97 | $81.21 |
| Madera, CA | $126.53 | $78.58 |
| Manhattan, NY | $133.58 | $82.74 |
| Marin County, CA | $149.02 | $87.33 |
| Merced, CA | $126.53 | $78.58 |
| Metropolitan Boston, MA | $133.66 | $81.41 |
| Metropolitan Kansas City, MO | $116.83 | $75.75 |
| Metropolitan Philadelphia, PA | $123.75 | $78.20 |
| Metropolitan St. Louis, MO | $117.57 | $75.91 |
| Miami, FL | $123.04 | $77.49 |
| Minnesota | $121.63 | $76.60 |
| Mississippi | $112.40 | $74.73 |
| Modesto, CA | $126.53 | $78.58 |
| Montana | $120.24 | $76.49 |
| Napa, CA | $141.86 | $84.19 |
| Nebraska | $115.74 | $75.35 |
| Nevada | $120.24 | $76.44 |
| New Hampshire | $122.49 | $76.94 |
| New Mexico | $115.68 | $75.56 |
| New Orleans, LA | $117.00 | $75.82 |
| North Carolina | $116.39 | $75.56 |
| North Dakota | $120.04 | $76.29 |
| Northern New Jersey | $133.23 | $82.47 |
| NYC suburbs and Long Island, NY | $135.18 | $83.15 |
| Ohio | $115.39 | $75.44 |
| Oklahoma | $114.20 | $75.13 |
| Oxnard, CA | $132.06 | $80.35 |
| Portland, OR | $127.38 | $78.76 |
| Poughkeepsie and northern NYC suburbs, NY | $128.50 | $80.59 |
| Puerto Rico | $120.85 | $76.62 |
| Queens, NY | $134.65 | $82.93 |
| Redding, CA | $126.53 | $78.58 |
| Rest of California | $126.53 | $78.58 |
| Rest of Florida | $117.96 | $76.13 |
| Rest of Georgia | $114.28 | $75.25 |
| Rest of Illinois | $115.58 | $75.63 |
| Rest of Louisiana | $113.81 | $75.09 |
| Rest of Maine | $115.65 | $75.40 |
| Rest of Maryland | $121.53 | $77.25 |
| Rest of Massachusetts | $124.16 | $78.08 |
| Rest of Michigan | $115.43 | $75.49 |
| Rest of Missouri | $112.54 | $74.82 |
| Rest of New Jersey | $127.97 | $80.19 |
| Rest of New York | $117.36 | $75.79 |
| Rest of Oregon | $119.92 | $76.34 |
| Rest of Pennsylvania | $115.65 | $75.48 |
| Rest of Texas | $117.37 | $75.84 |
| Rest of Washington | $123.95 | $77.88 |
| Rhode Island | $123.27 | $78.07 |
| Riverside, CA | $126.70 | $78.75 |
| Sacramento, CA | $131.49 | $80.60 |
| Salinas, CA | $130.95 | $80.23 |
| San Benito County, CA | $151.80 | $88.70 |
| San Diego, CA | $132.95 | $80.62 |
| San Francisco, CA | $149.01 | $87.32 |
| San Luis Obispo, CA | $128.93 | $79.09 |
| Santa Clara County, CA | $151.75 | $88.66 |
| Santa Cruz, CA | $133.43 | $80.27 |
| Santa Maria, CA | $131.14 | $80.12 |
| Santa Rosa, CA | $134.73 | $81.00 |
| South Carolina | $115.95 | $75.52 |
| South Dakota | $120.02 | $76.27 |
| Southern Maine, ME | $119.62 | $76.26 |
| Stockton, CA | $126.53 | $78.58 |
| Suburban Chicago, IL | $122.46 | $77.52 |
| Tennessee | $115.01 | $75.24 |
| Utah | $116.86 | $75.73 |
| Vallejo, CA | $141.84 | $84.17 |
| Vermont | $119.52 | $76.20 |
| Virgin Islands, VI | $120.85 | $76.62 |
| Virginia | $119.20 | $76.19 |
| Visalia, CA | $126.53 | $78.58 |
| Washington, DC area | $133.67 | $82.13 |
| West Virginia | $113.08 | $75.06 |
| Wisconsin | $117.67 | $75.75 |
| Wyoming | $120.16 | $76.40 |
| Yuba City, CA | $126.53 | $78.58 |
92072 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$112.22
$155.78
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $155.78 | 1 |
| AL | $113.13 | 1 |
| AR | $112.22 | 1 |
| AZ | $118.47 | 1 |
| CA | $126.53–$151.80 | 29 |
| CO | $124.51 | 1 |
| CT | $125.89 | 1 |
| DC | $133.67 | 1 |
| DE | $119.86 | 1 |
| FL | $117.96–$123.04 | 3 |
| GA | $114.28–$121.40 | 2 |
| GU | $127.74 | 1 |
| HI | $127.74 | 1 |
| IA | $115.30 | 1 |
| ID | $115.60 | 1 |
| IL | $115.58–$122.46 | 4 |
| IN | $116.00 | 1 |
| KS | $114.72 | 1 |
| KY | $114.02 | 1 |
| LA | $113.81–$117.00 | 2 |
| MA | $124.16–$133.66 | 2 |
| MD | $121.53–$133.67 | 3 |
| ME | $115.65–$119.62 | 2 |
| MI | $115.43–$118.52 | 2 |
| MN | $121.63 | 1 |
| MO | $112.54–$117.57 | 3 |
| MS | $112.40 | 1 |
| MT | $120.24 | 1 |
| NC | $116.39 | 1 |
| ND | $120.04 | 1 |
| NE | $115.74 | 1 |
| NH | $122.49 | 1 |
| NJ | $127.97–$133.23 | 2 |
| NM | $115.68 | 1 |
| NV | $120.24 | 1 |
| NY | $117.36–$135.18 | 5 |
| OH | $115.39 | 1 |
| OK | $114.20 | 1 |
| OR | $119.92–$127.38 | 2 |
| PA | $115.65–$123.75 | 2 |
| PR | $120.85 | 1 |
| RI | $123.27 | 1 |
| SC | $115.95 | 1 |
| SD | $120.02 | 1 |
| TN | $115.01 | 1 |
| TX | $115.20–$123.57 | 8 |
| UT | $116.86 | 1 |
| VA | $119.20–$133.67 | 2 |
| VI | $120.85 | 1 |
| VT | $119.52 | 1 |
| WA | $123.95–$136.05 | 2 |
| WI | $117.67 | 1 |
| WV | $113.08 | 1 |
| WY | $120.16 | 1 |
How the 92072 rate is calculated
Each of 92072’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 92072
RVUs × geographic indexes × conversion factor
Work1.92
1.92 RVUs× 1.000 GPCI
Practice expense1.67
1.67 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
3.6000
Conversion factor
$33.4009
Medicare rate
$120.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92072
The CMS indicators that decide how 92072 is paid alongside other services.
CMS payment indicators · 92072
Contact lens fitting, keratoconus, initial
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
92072 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92071Contact lens fittingOcular surface treatment
- Choose 92072 for an initial contact lens fitting to manage keratoconus. Choose 92071 when the lens is fitted to treat an ocular-surface condition.
- 92310Contact lens fittingBoth eyes; non-aphakic
- 92310 describes a general contact lens fitting. 92072 is the keratoconus-specific code for the initial fitting.
- 92025Corneal topographyComputerized curvature map
- 92025 reports computerized corneal topography, not the contact lens fitting itself. 92072 reports the initial fitting for keratoconus.
92072 billing questions
How is 92072 different from 92071?
92072 is for an initial contact lens fitting to manage keratoconus. 92071 is for fitting a contact lens to treat an ocular-surface condition.
Can 92072 be reported for one eye?
Yes. CMS prices 92072 as bilateral even when the fitting involves only one eye.
Should modifier 50 be appended?
Modifier 50 does not increase payment for 92072 because CMS already prices the code as bilateral.
Is corneal topography part of the fitting?
92072 represents the contact lens fitting, while 92025 represents computerized corneal topography. Report topography separately only when it is performed and documented as a distinct service.
What documentation supports 92072?
Document keratoconus as the reason for the fitting and describe the lens assessment, including fit and clinical evaluation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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