CPT code 92072: Contact lens fitting, keratoconus, initial2026 Medicare rate & RVUs in South Dakota
An initial specialty contact lens fitting for keratoconus, reported when an eye-care clinician selects and evaluates a lens to manage corneal irregularity.
In South Dakota, Medicare pays $120.02 for 92072 in the office and $76.27 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How South Dakota 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. South Dakota pays $120.02. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$120.02
- Los Angeles, CA · California$132.97+$12.95
- Washington, DC area · District of Columbia$133.67+$13.65
- Miami, FL · Florida$123.04+$3.02
- Chicago, IL · Illinois$121.40+$1.38
- Manhattan, NY · New York$133.58+$13.56
- Alaska · Alaska$155.78+$35.76
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| El Centro, CACalifornia | $126.53 | $78.58 |
| Fresno, CACalifornia | $126.53 | $78.58 |
| Hanford, CACalifornia | $126.53 | $78.58 |
| Madera, CACalifornia | $126.53 | $78.58 |
| Merced, CACalifornia | $126.53 | $78.58 |
| Modesto, CACalifornia | $126.53 | $78.58 |
| Napa, CACalifornia | $141.86 | $84.19 |
| Oxnard, CACalifornia | $132.06 | $80.35 |
| Redding, CACalifornia | $126.53 | $78.58 |
| Rest of CaliforniaCalifornia | $126.53 | $78.58 |
| Riverside, CACalifornia | $126.70 | $78.75 |
| Sacramento, CACalifornia | $131.49 | $80.60 |
| Salinas, CACalifornia | $130.95 | $80.23 |
| San Diego, CACalifornia | $132.95 | $80.62 |
| Marin County, CACalifornia | $149.02 | $87.33 |
| San Francisco, CACalifornia | $149.01 | $87.32 |
| San Benito County, CACalifornia | $151.80 | $88.70 |
| Santa Clara County, CACalifornia | $151.75 | $88.66 |
| San Luis Obispo, CACalifornia | $128.93 | $79.09 |
| Santa Cruz, CACalifornia | $133.43 | $80.27 |
| Santa Maria, CACalifornia | $131.14 | $80.12 |
| Santa Rosa, CACalifornia | $134.73 | $81.00 |
| Stockton, CACalifornia | $126.53 | $78.58 |
| Vallejo, CACalifornia | $141.84 | $84.17 |
| Visalia, CACalifornia | $126.53 | $78.58 |
| Yuba City, CACalifornia | $126.53 | $78.58 |
| ColoradoColorado | $124.51 | $77.95 |
| ConnecticutConnecticut | $125.89 | $78.77 |
| DelawareDelaware | $119.86 | $76.63 |
| Fort Lauderdale, FLFlorida | $121.24 | $76.91 |
| Rest of FloridaFlorida | $117.96 | $76.13 |
| Atlanta, GAGeorgia | $121.40 | $76.94 |
| Rest of GeorgiaGeorgia | $114.28 | $75.25 |
| Hawaii, Guam, HIHawaii | $127.74 | $77.99 |
| IowaIowa | $115.30 | $75.26 |
| IdahoIdaho | $115.60 | $75.35 |
| East St. Louis, ILIllinois | $116.12 | $75.86 |
| Rest of IllinoisIllinois | $115.58 | $75.63 |
| Suburban Chicago, ILIllinois | $122.46 | $77.52 |
| IndianaIndiana | $116.00 | $75.44 |
| KansasKansas | $114.72 | $75.17 |
| KentuckyKentucky | $114.02 | $75.12 |
| New Orleans, LALouisiana | $117.00 | $75.82 |
| Rest of LouisianaLouisiana | $113.81 | $75.09 |
| Metropolitan Boston, MAMassachusetts | $133.66 | $81.41 |
| Rest of MassachusettsMassachusetts | $124.16 | $78.08 |
| Baltimore area, MDMaryland | $125.42 | $78.47 |
| Rest of MarylandMaryland | $121.53 | $77.25 |
| Rest of MaineMaine | $115.65 | $75.40 |
| Southern Maine, MEMaine | $119.62 | $76.26 |
| Detroit, MIMichigan | $118.52 | $76.30 |
| Rest of MichiganMichigan | $115.43 | $75.49 |
| MinnesotaMinnesota | $121.63 | $76.60 |
| Metropolitan Kansas City, MOMissouri | $116.83 | $75.75 |
| Metropolitan St. Louis, MOMissouri | $117.57 | $75.91 |
| Rest of MissouriMissouri | $112.54 | $74.82 |
| MississippiMississippi | $112.40 | $74.73 |
| MontanaMontana | $120.24 | $76.49 |
| North CarolinaNorth Carolina | $116.39 | $75.56 |
| North DakotaNorth Dakota | $120.04 | $76.29 |
| NebraskaNebraska | $115.74 | $75.35 |
| New HampshireNew Hampshire | $122.49 | $76.94 |
| Northern New JerseyNew Jersey | $133.23 | $82.47 |
| Rest of New JerseyNew Jersey | $127.97 | $80.19 |
| New MexicoNew Mexico | $115.68 | $75.56 |
| NevadaNevada | $120.24 | $76.44 |
| NYC suburbs and Long Island, NYNew York | $135.18 | $83.15 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $128.50 | $80.59 |
| Queens, NYNew York | $134.65 | $82.93 |
| Rest of New YorkNew York | $117.36 | $75.79 |
| OhioOhio | $115.39 | $75.44 |
| OklahomaOklahoma | $114.20 | $75.13 |
| Portland, OROregon | $127.38 | $78.76 |
| Rest of OregonOregon | $119.92 | $76.34 |
| Metropolitan Philadelphia, PAPennsylvania | $123.75 | $78.20 |
| Rest of PennsylvaniaPennsylvania | $115.65 | $75.48 |
| Puerto RicoPuerto Rico | $120.85 | $76.62 |
| Rhode IslandRhode Island | $123.27 | $78.07 |
| South CarolinaSouth Carolina | $115.95 | $75.52 |
| TennesseeTennessee | $115.01 | $75.24 |
| Austin, TXTexas | $123.57 | $77.28 |
| Beaumont, TXTexas | $115.20 | $75.38 |
| Brazoria, TXTexas | $120.18 | $76.82 |
| Dallas, TXTexas | $120.55 | $76.97 |
| Fort Worth, TXTexas | $120.00 | $76.85 |
| Galveston, TXTexas | $120.31 | $76.86 |
| Houston, TXTexas | $120.49 | $77.04 |
| Rest of TexasTexas | $117.37 | $75.84 |
| UtahUtah | $116.86 | $75.73 |
| VirginiaVirginia | $119.20 | $76.19 |
| Virgin Islands, VIUnited States Virgin Islands | $120.85 | $76.62 |
| VermontVermont | $119.52 | $76.20 |
| Rest of WashingtonWashington | $123.95 | $77.88 |
| King County, WAWashington | $136.05 | $82.36 |
| WisconsinWisconsin | $117.67 | $75.75 |
| West VirginiaWest Virginia | $113.08 | $75.06 |
| WyomingWyoming | $120.16 | $76.40 |
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.
The exact South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.92 | × 1.000 | 1.9200 |
| Practice expense | 1.67 | × 1.000 | 1.6700 |
| Malpractice | 0.01 | × 0.336 | 0.0034 |
| Total RVUs | 3.5934 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$120.02
Office: (1.92 × 1 + 1.67 × 1 + 0.01 × 0.336) × $33.4009 = $120.02
Facility: (1.92 × 1 + 0.36 × 1 + 0.01 × 0.336) × $33.4009 = $76.27
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. |
How 92072 has changed in South Dakota
92072 · Office / nonfacility
$120.02
Effective 2026-10-01
The base rate is $0.74 higher than on 2025-10-01, moving from $119.28 to $120.02 (0.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$119.28changed to$120.02
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$123.75changed to$119.28
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.74 changed to 1.71
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$121.73changed to$123.75
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$126.65changed to$121.73
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.76 changed to 1.74
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$128.18changed to$126.65
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$129.24changed to$128.18
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$129.96changed to$129.24
- 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
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$132.52changed to$129.96
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$134.18changed to$132.52
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.73 changed to 1.68
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$134.50changed to$134.18
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.75 changed to 1.73
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$134.91changed to$134.50
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.77 changed to 1.75
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$134.89changed to$134.91
- 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.
July 1, 2015
RVU15C
$134.22changed to$134.89
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$137.41changed to$134.22
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$125.80changed to$137.41
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.68 changed to 1.82
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $125.80
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $120.02 | $76.27 | RVU26D |
| 2026-07-01 | $120.02 | $76.27 | RVU26C |
| 2026-04-01 | $120.02 | $76.27 | RVU26B |
| 2026-01-01 | $120.02 | $76.27 | RVU26A |
| 2025-10-01 | $119.28 | $88.23 | RVU25D |
| 2025-07-01 | $119.28 | $88.23 | RVU25C |
| 2025-04-01 | $119.28 | $88.23 | RVU25B |
| 2025-01-01 | $119.28 | $88.23 | RVU25A |
| 2024-10-01 | $123.75 | $91.13 | RVU24D |
| 2024-07-01 | $123.75 | $91.13 | RVU24C |
| 2024-04-01 | $123.75 | $91.13 | RVU24B |
| 2024-03-09 | $123.75 | $91.13 | RVU24AR |
| 2024-01-01 | $121.73 | $89.64 | RVU24A |
| 2023-10-01 | $126.65 | $93.78 | RVU23D |
| 2023-07-01 | $126.65 | $93.78 | RVU23C |
| 2023-04-01 | $126.65 | $93.78 | RVU23B |
| 2023-01-01 | $126.65 | $93.78 | RVU23A |
| 2022-10-01 | $128.18 | $95.30 | RVU22D |
| 2022-07-01 | $128.18 | $95.30 | RVU22C |
| 2022-04-01 | $128.18 | $95.30 | RVU22B |
| 2022-01-01 | $128.18 | $95.30 | RVU22A |
| 2021-10-01 | $129.24 | $96.44 | RVU21D |
| 2021-07-01 | $129.24 | $96.44 | RVU21C |
| 2021-04-01 | $129.24 | $96.44 | RVU21B |
| 2021-01-01 | $129.24 | $96.44 | RVU21A |
| 2020-10-01 | $129.96 | $98.92 | RVU20D |
| 2020-07-01 | $129.96 | $98.92 | RVU20C |
| 2020-04-01 | $129.96 | $98.92 | RVU20B |
| 2020-01-01 | $129.96 | $98.92 | RVU20A |
| 2019-10-01 | $132.52 | $100.81 | RVU19D |
| 2019-07-01 | $132.52 | $100.81 | RVU19C |
| 2019-04-01 | $132.52 | $100.81 | RVU19B |
| 2019-01-01 | $132.52 | $100.81 | RVU19A |
| 2018-10-01 | $134.18 | $101.78 | RVU18D |
| 2018-07-01 | $134.18 | $101.78 | RVU18C |
| 2018-04-01 | $134.18 | $101.78 | RVU18B |
| 2018-01-01 | $134.18 | $101.78 | RVU18AR1 |
| 2017-10-01 | $134.50 | $102.92 | RVU17D |
| 2017-07-01 | $134.50 | $102.92 | RVU17C |
| 2017-04-01 | $134.50 | $102.92 | RVU17B |
| 2017-01-01 | $134.50 | $102.92 | RVU17A |
| 2016-10-01 | $134.91 | $103.04 | RVU16D |
| 2016-07-01 | $134.91 | $103.04 | RVU16C |
| 2016-04-01 | $134.91 | $103.04 | RVU16B |
| 2016-01-01 | $134.91 | $103.04 | RVU16A |
| 2015-10-01 | $134.89 | $102.91 | RVU15D |
| 2015-07-01 | $134.89 | $102.91 | RVU15C |
| 2015-04-01 | $134.22 | $102.40 | RVU15B |
| 2015-01-01 | $134.22 | $102.40 | RVU15A |
| 2014-10-01 | $137.41 | $105.88 | RVU14D |
| 2014-07-01 | $137.41 | $105.88 | RVU14C |
| 2014-04-01 | $137.41 | $105.88 | RVU14B |
| 2014-01-01 | $137.41 | $105.88 | RVU14A |
| 2013-10-01 | $125.80 | $95.86 | RVU13D |
| 2013-07-01 | $125.80 | $95.86 | RVU13C |
| 2013-04-01 | $125.80 | $95.86 | RVU13B |
| 2013-01-01 | $125.80 | $95.86 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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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