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CPT code 92072: Contact lens fitting, keratoconus, initial2026 Medicare rate & RVUs in Queens, NY

An initial specialty contact lens fitting for keratoconus, reported when an eye-care clinician selects and evaluates a lens to manage corneal irregularity.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Queens, NY, Medicare pays $134.65 for 92072 in the office and $82.93 when it’s performed in a hospital or facility.

$134.65Office (non-facility)
$82.93Hospital or facility
+12.0%vs the national office rate ($120.24)

Check a contract rate as a % of Medicare · 92072 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 92072 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 92072 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Queens, NY compares for 92072

Across 109 of 109 payment localities, the office rate for 92072 runs from $112.22 in Arkansas to $155.78 in Alaska. Queens, NY pays $134.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

92072 in Queens, NY vs other payment areas
  1. Queens, NY · this page$134.65
  2. Manhattan, NY · New York$133.58−$1.07
  3. NYC suburbs and Long Island, NY · New York$135.18+$0.53
  4. Poughkeepsie and northern NYC suburbs, NY · New York$128.50−$6.15
  5. Rest of New York · New York$117.36−$17.29
  6. Los Angeles, CA · California$132.97−$1.68
  7. Washington, DC area · District of Columbia$133.67−$0.98

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

92072 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$123.04$77.49
Chicago, ILIllinois$121.40$77.43
AlaskaAlaska$155.78$109.18
AlabamaAlabama$113.13$74.84
ArkansasArkansas$112.22$74.63
ArizonaArizona$118.47$76.07
Bakersfield, CACalifornia$126.69$78.73
Chico, CACalifornia$126.53$78.58

92072 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
92072 office rate range by state
State / territoryOffice rate rangeLocalities
AK$155.781
AL$113.131
AR$112.221
AZ$118.471
CA$126.53–$151.8029
CO$124.511
CT$125.891
DC$133.671
DE$119.861
FL$117.96–$123.043
GA$114.28–$121.402
GU$127.741
HI$127.741
IA$115.301
ID$115.601
IL$115.58–$122.464
IN$116.001
KS$114.721
KY$114.021
LA$113.81–$117.002
MA$124.16–$133.662
MD$121.53–$133.673
ME$115.65–$119.622
MI$115.43–$118.522
MN$121.631
MO$112.54–$117.573
MS$112.401
MT$120.241
NC$116.391
ND$120.041
NE$115.741
NH$122.491
NJ$127.97–$133.232
NM$115.681
NV$120.241
NY$117.36–$135.185
OH$115.391
OK$114.201
OR$119.92–$127.382
PA$115.65–$123.752
PR$120.851
RI$123.271
SC$115.951
SD$120.021
TN$115.011
TX$115.20–$123.578
UT$116.861
VA$119.20–$133.672
VI$120.851
VT$119.521
WA$123.95–$136.052
WI$117.671
WV$113.081
WY$120.161

See 92072 in every payment locality

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

Office or facility?

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.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,676

Code
92072
Physician work
1.92
Practice expense
1.67
Malpractice
0.01

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 92072 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.92× 1.0642.0429
Practice expense1.67× 1.1821.9739
Malpractice0.01× 1.4420.0144
Total RVUs4.0312
Conversion factor× 33.4009

Office rate, Queens, NY$134.65

Office: (1.92 × 1.064 + 1.67 × 1.182 + 0.01 × 1.442) × $33.4009 = $134.65

Facility: (1.92 × 1.064 + 0.36 × 1.182 + 0.01 × 1.442) × $33.4009 = $82.93

Open 92072 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 92072

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 92072
CodeHow it relatesOffice range, Queens, NY
Used instead
92071Contact lens fitting, ocular surface treatmentFits a contact lens for an ocular-surface treatment indication rather than keratoconus management.$40.09
92310Contact lens fitting, both eyes; non-aphakicGeneral contact lens fitting for a different indication, rather than the keratoconus-specific initial fitting.No office rate
Often billed with
92025Corneal topography, computerized curvature mapComputerized corneal topography may be performed to assess corneal shape during keratoconus care.$42.66

How 92072 has changed in Queens, NY

92072 · Office / nonfacility

$134.65

Effective 2026-10-01

The base rate is $0.26 lower than on 2025-10-01, moving from $134.91 to $134.65 (0.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $134.91changed to$134.65

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.97 changed to 1.92
    • Practice expense RVU 1.71 changed to 1.67
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $140.03changed to$134.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.74 changed to 1.71

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $137.74changed to$140.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $144.51changed to$137.74

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.76 changed to 1.74
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $148.77changed to$144.51

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.72 changed to 1.76
    • Malpractice RVU 0.04 changed to 0.02
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $150.00changed to$148.77

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $148.50changed to$150.00

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.62 changed to 1.72
    • Malpractice RVU 0.03 changed to 0.04
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $152.69changed to$148.50

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.68 changed to 1.62
    • Malpractice RVU 0.07 changed to 0.03
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $154.69changed to$152.69

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.73 changed to 1.68

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $155.15changed to$154.69

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.75 changed to 1.73
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $155.65changed to$155.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.77 changed to 1.75
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $155.00changed to$155.65

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.76 changed to 1.77
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $154.23changed to$155.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $159.87changed to$154.23

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.82 changed to 1.76
    • Malpractice RVU 0.11 changed to 0.06
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $145.07changed to$159.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.68 changed to 1.82
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $145.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$134.65$82.93RVU26D
2026-07-01$134.65$82.93RVU26C
2026-04-01$134.65$82.93RVU26B
2026-01-01$134.65$82.93RVU26A
2025-10-01$134.91$97.80RVU25D
2025-07-01$134.91$97.80RVU25C
2025-04-01$134.91$97.80RVU25B
2025-01-01$134.91$97.80RVU25A
2024-10-01$140.03$101.04RVU24D
2024-07-01$140.03$101.04RVU24C
2024-04-01$140.03$101.04RVU24B
2024-03-09$140.03$101.04RVU24AR
2024-01-01$137.74$99.39RVU24A
2023-10-01$144.51$104.67RVU23D
2023-07-01$144.51$104.67RVU23C
2023-04-01$144.51$104.67RVU23B
2023-01-01$144.51$104.67RVU23A
2022-10-01$148.77$108.40RVU22D
2022-07-01$148.77$108.40RVU22C
2022-04-01$148.77$108.40RVU22B
2022-01-01$148.77$108.40RVU22A
2021-10-01$150.00$109.72RVU21D
2021-07-01$150.00$109.72RVU21C
2021-04-01$150.00$109.72RVU21B
2021-01-01$150.00$109.72RVU21A
2020-10-01$148.50$110.82RVU20D
2020-07-01$148.50$110.82RVU20C
2020-04-01$148.50$110.82RVU20B
2020-01-01$148.50$110.82RVU20A
2019-10-01$152.69$114.64RVU19D
2019-07-01$152.69$114.64RVU19C
2019-04-01$152.69$114.64RVU19B
2019-01-01$152.69$114.64RVU19A
2018-10-01$154.69$115.81RVU18D
2018-07-01$154.69$115.81RVU18C
2018-04-01$154.69$115.81RVU18B
2018-01-01$154.69$115.81RVU18AR1
2017-10-01$155.15$117.25RVU17D
2017-07-01$155.15$117.25RVU17C
2017-04-01$155.15$117.25RVU17B
2017-01-01$155.15$117.25RVU17A
2016-10-01$155.65$117.45RVU16D
2016-07-01$155.65$117.45RVU16C
2016-04-01$155.65$117.45RVU16B
2016-01-01$155.65$117.45RVU16A
2015-10-01$155.00$116.66RVU15D
2015-07-01$155.00$116.66RVU15C
2015-04-01$154.23$116.08RVU15B
2015-01-01$154.23$116.08RVU15A
2014-10-01$159.87$122.14RVU14D
2014-07-01$159.87$122.14RVU14C
2014-04-01$159.87$122.14RVU14B
2014-01-01$159.87$122.14RVU14A
2013-10-01$145.07$109.29RVU13D
2013-07-01$145.07$109.29RVU13C
2013-04-01$145.07$109.29RVU13B
2013-01-01$145.07$109.29RVU13AR

Price 92072 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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
RVUs for 92072PPRRVU2026_Oct_nonQPP.csv, line 11,676 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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