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

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 Virginia, Medicare pays $119.20 for 92072 in the office and $76.19 when it’s performed in a hospital or facility.

$119.20Office (non-facility)
$76.19Hospital or facility
−0.9%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 Virginia
  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 Virginia 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. Virginia pays $119.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

92072 in Virginia vs other payment areas
  1. Virginia · this page$119.20
  2. Los Angeles, CA · California$132.97+$13.77
  3. Washington, DC area · District of Columbia$133.67+$14.47
  4. Miami, FL · Florida$123.04+$3.84
  5. Chicago, IL · Illinois$121.40+$2.20
  6. Manhattan, NY · New York$133.58+$14.38
  7. Alaska · Alaska$155.78+$36.58

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

Every other payment area

92072 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 92072 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.92× 1.0001.9200
Practice expense1.67× 0.9831.6416
Malpractice0.01× 0.7060.0071
Total RVUs3.5687
Conversion factor× 33.4009

Office rate, Virginia$119.20

Office: (1.92 × 1 + 1.67 × 0.983 + 0.01 × 0.706) × $33.4009 = $119.20

Facility: (1.92 × 1 + 0.36 × 0.983 + 0.01 × 0.706) × $33.4009 = $76.19

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.

How 92072 has changed in Virginia

92072 · Office / nonfacility

$119.20

Effective 2026-10-01

The base rate is $0.43 higher than on 2025-10-01, moving from $118.77 to $119.20 (0.4%).

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

    $118.77changed to$119.20

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $123.20changed to$118.77

    • 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

    $121.19changed to$123.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $126.36changed to$121.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.76 changed to 1.74
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $128.64changed to$126.36

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $129.71changed to$128.64

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $130.01changed to$129.71

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $132.99changed to$130.01

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $134.61changed to$132.99

    • 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

    $134.74changed to$134.61

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.75 changed to 1.73
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $134.90changed to$134.74

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.77 changed to 1.75
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $134.73changed to$134.90

    • 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

    $134.06changed to$134.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $137.53changed to$134.06

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $125.61changed to$137.53

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.68 changed to 1.82
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $125.61

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$119.20$76.19RVU26D
2026-07-01$119.20$76.19RVU26C
2026-04-01$119.20$76.19RVU26B
2026-01-01$119.20$76.19RVU26A
2025-10-01$118.77$88.21RVU25D
2025-07-01$118.77$88.21RVU25C
2025-04-01$118.77$88.21RVU25B
2025-01-01$118.77$88.21RVU25A
2024-10-01$123.20$91.10RVU24D
2024-07-01$123.20$91.10RVU24C
2024-04-01$123.20$91.10RVU24B
2024-03-09$123.20$91.10RVU24AR
2024-01-01$121.19$89.62RVU24A
2023-10-01$126.36$93.82RVU23D
2023-07-01$126.36$93.82RVU23C
2023-04-01$126.36$93.82RVU23B
2023-01-01$126.36$93.82RVU23A
2022-10-01$128.64$95.93RVU22D
2022-07-01$128.64$95.93RVU22C
2022-04-01$128.64$95.93RVU22B
2022-01-01$128.64$95.93RVU22A
2021-10-01$129.71$97.07RVU21D
2021-07-01$129.71$97.07RVU21C
2021-04-01$129.71$97.07RVU21B
2021-01-01$129.71$97.07RVU21A
2020-10-01$130.01$99.26RVU20D
2020-07-01$130.01$99.26RVU20C
2020-04-01$130.01$99.26RVU20B
2020-01-01$130.01$99.26RVU20A
2019-10-01$132.99$101.72RVU19D
2019-07-01$132.99$101.72RVU19C
2019-04-01$132.99$101.72RVU19B
2019-01-01$132.99$101.72RVU19A
2018-10-01$134.61$102.67RVU18D
2018-07-01$134.61$102.67RVU18C
2018-04-01$134.61$102.67RVU18B
2018-01-01$134.61$102.67RVU18AR1
2017-10-01$134.74$103.63RVU17D
2017-07-01$134.74$103.63RVU17C
2017-04-01$134.74$103.63RVU17B
2017-01-01$134.74$103.63RVU17A
2016-10-01$134.90$103.57RVU16D
2016-07-01$134.90$103.57RVU16C
2016-04-01$134.90$103.57RVU16B
2016-01-01$134.90$103.57RVU16A
2015-10-01$134.73$103.30RVU15D
2015-07-01$134.73$103.30RVU15C
2015-04-01$134.06$102.78RVU15B
2015-01-01$134.06$102.78RVU15A
2014-10-01$137.53$106.64RVU14D
2014-07-01$137.53$106.64RVU14C
2014-04-01$137.53$106.64RVU14B
2014-01-01$137.53$106.64RVU14A
2013-10-01$125.61$96.35RVU13D
2013-07-01$125.61$96.35RVU13C
2013-04-01$125.61$96.35RVU13B
2013-01-01$125.61$96.35RVU13AR

Price 92072 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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