CPT code 92311: Contact lens fitting, aphakia, one eye2026 Medicare rate & RVUs in Washington, DC area

Reports the clinical fitting of a contact lens for one aphakic eye, including lens selection, fit assessment, and medical oversight during adaptation.

CMS RVU26DEffective Oct 1, 2026One payment locality251 Medicare services in 2024

In Washington, DC area, Medicare pays $112.09 for 92311 in the office and $45.21 when it’s performed in a hospital or facility.

$112.09Office (non-facility)
$45.21Hospital or facility
+13.4%vs the national office rate ($98.87)

Check a contract rate as a % of Medicare · 92311 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 92311 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 92311 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 92311 covers

92311 covers contact lens fitting for one aphakic eye, meaning the eye lacks its natural crystalline lens. A typical situation is aphakia after cataract removal when no intraocular lens was placed; congenital aphakia is another possible cause. An ophthalmologist or optometrist selects the lens characteristics, evaluates fit and visual effect, and oversees the patient’s adaptation. The service may include trial-lens assessment and instruction in lens handling, usually in an eye-care office.

Report 92311 for fitting one eye. When both aphakic eyes are fitted, 92312 is the bilateral sibling rather than two units of 92311. Documentation should identify the eye and support the aphakic diagnosis, fitting performed, and lens characteristics selected. Distinguish a fitting from a routine fitting for an eye without aphakia, a technician-performed fitting, or a later lens adjustment or replacement. CMS values the service using physician work, practice expense, and malpractice inputs; the practice-expense inputs differ between office and facility settings.

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 Washington, DC area compares for 92311

Across 109 of 109 payment localities, the office rate for 92311 runs from $89.76 in Arkansas to $130.62 in San Benito County, CA. Washington, DC area pays $112.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

92311 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$112.09
  2. Los Angeles, CA · California$111.81−$0.28
  3. Miami, FL · Florida$101.98−$10.11
  4. Chicago, IL · Illinois$99.86−$12.23
  5. Manhattan, NY · New York$111.59−$0.50
  6. Alaska · Alaska$120.38+$8.29
  7. Alabama · Alabama$90.79−$21.30

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

92311 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$89.76$40.98
ArizonaArizona$96.85$41.83
Bakersfield, CACalifornia$105.49$43.26
Chico, CACalifornia$105.40$43.17
El Centro, CACalifornia$105.40$43.17
Fresno, CACalifornia$105.40$43.17
Hanford, CACalifornia$105.40$43.17
Madera, CACalifornia$105.40$43.17

92311 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.

$89.76

$120.38

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92311 office rate range by state
State / territoryOffice rate rangeLocalities
AK$120.381
AL$90.791
AR$89.761
AZ$96.851
CA$105.40–$130.6229
CO$103.281
CT$104.521
DC$112.091
DE$98.251
FL$96.24–$101.983
GA$92.08–$100.052
GU$107.421
HI$107.421
IA$93.271
ID$93.611
IL$93.53–$101.084
IN$94.061
KS$92.611
KY$91.791
LA$91.55–$95.172
MA$102.72–$112.582
MD$99.95–$112.093
ME$93.66–$98.172
MI$93.39–$96.872
MN$100.471
MO$90.10–$95.823
MS$89.961
MT$98.871
NC$94.491
ND$98.671
NE$93.771
NH$101.431
NJ$106.14–$111.252
NM$93.671
NV$98.871
NY$95.59–$113.395
OH$93.351
OK$92.001
OR$98.51–$106.392
PA$93.64–$102.162
PR$99.561
RI$101.591
SC$93.991
SD$98.641
TN$92.941
TX$93.13–$102.588
UT$95.021
VA$97.69–$112.092
VI$99.561
VT$98.071
WA$102.61–$114.962
WI$95.971
WV$90.701
WY$98.781

See 92311 in every payment locality

How the 92311 rate is calculated

Each of 92311’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 · 92311

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.05

1.05 RVUs× 1.000 GPCI

Practice expense1.90

1.90 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

2.9600

Conversion factor

$33.4009

Medicare rate

$98.87

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,755

Code
92311
Physician work
1.05
Practice expense
1.90
Malpractice
0.01

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 92311 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.05× 1.0541.1067
Practice expense1.90× 1.1782.2382
Malpractice0.01× 1.1130.0111
Total RVUs3.3560
Conversion factor× 33.4009

Office rate, Washington, DC area$112.09

Office: (1.05 × 1.054 + 1.9 × 1.178 + 0.01 × 1.113) × $33.4009 = $112.09

Facility: (1.05 × 1.054 + 0.2 × 1.178 + 0.01 × 1.113) × $33.4009 = $45.21

Open 92311 in the RVU calculator

Payment rules and modifiers for 92311

92311 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 92311

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$98.87

Non-facility (office)
$98.87
Facility
$42.09

Higher because the practice carries its own overhead.

How 92311 has changed in Washington, DC area

92311 · Office / nonfacility

$112.09

Effective 2026-10-01

The base rate is $0.79 lower than on 2025-10-01, moving from $112.88 to $112.09 (0.7%).

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

    $112.88changed to$112.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.08 changed to 1.05
    • Practice expense RVU 1.96 changed to 1.90
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $117.75changed to$112.88

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.00 changed to 1.96

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $115.82changed to$117.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $122.99changed to$115.82

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.04 changed to 2.00
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $127.12changed to$122.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.03 changed to 2.04
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $128.17changed to$127.12

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $123.33changed to$128.17

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.85 changed to 2.03
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $121.53changed to$123.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.82 changed to 1.85
    • Malpractice RVU 0.04 changed to 0.02
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $119.23changed to$121.53

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.77 changed to 1.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $117.26changed to$119.23

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.73 changed to 1.77
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $117.11changed to$117.26

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $117.10changed to$117.11

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.72 changed to 1.73

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $116.52changed to$117.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $118.57changed to$116.52

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.73 changed to 1.72
    • Malpractice RVU 0.08 changed to 0.04
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $120.69changed to$118.57

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.94 changed to 1.73
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $120.69

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$112.09$45.21RVU26D
2026-07-01$112.09$45.21RVU26C
2026-04-01$112.09$45.21RVU26B
2026-01-01$112.09$45.21RVU26A
2025-10-01$112.88$53.11RVU25D
2025-07-01$112.88$53.11RVU25C
2025-04-01$112.88$53.11RVU25B
2025-01-01$112.88$53.11RVU25A
2024-10-01$117.75$55.05RVU24D
2024-07-01$117.75$55.05RVU24C
2024-04-01$117.75$55.05RVU24B
2024-03-09$117.75$55.05RVU24AR
2024-01-01$115.82$54.15RVU24A
2023-10-01$122.99$57.17RVU23D
2023-07-01$122.99$57.17RVU23C
2023-04-01$122.99$57.17RVU23B
2023-01-01$122.99$57.17RVU23A
2022-10-01$127.12$58.68RVU22D
2022-07-01$127.12$58.68RVU22C
2022-04-01$127.12$58.68RVU22B
2022-01-01$127.12$58.68RVU22A
2021-10-01$128.17$60.03RVU21D
2021-07-01$128.17$60.03RVU21C
2021-04-01$128.17$60.03RVU21B
2021-01-01$128.17$60.03RVU21A
2020-10-01$123.33$61.20RVU20D
2020-07-01$123.33$61.20RVU20C
2020-04-01$123.33$61.20RVU20B
2020-01-01$123.33$61.20RVU20A
2019-10-01$121.53$62.03RVU19D
2019-07-01$121.53$62.03RVU19C
2019-04-01$121.53$62.03RVU19B
2019-01-01$121.53$62.03RVU19A
2018-10-01$119.23$61.97RVU18D
2018-07-01$119.23$61.97RVU18C
2018-04-01$119.23$61.97RVU18B
2018-01-01$119.23$61.97RVU18AR1
2017-10-01$117.26$62.34RVU17D
2017-07-01$117.26$62.34RVU17C
2017-04-01$117.26$62.34RVU17B
2017-01-01$117.26$62.34RVU17A
2016-10-01$117.11$62.32RVU16D
2016-07-01$117.11$62.32RVU16C
2016-04-01$117.11$62.32RVU16B
2016-01-01$117.11$62.32RVU16A
2015-10-01$117.10$62.11RVU15D
2015-07-01$117.10$62.11RVU15C
2015-04-01$116.52$61.80RVU15B
2015-01-01$116.52$61.80RVU15A
2014-10-01$118.57$64.31RVU14D
2014-07-01$118.57$64.31RVU14C
2014-04-01$118.57$64.31RVU14B
2014-01-01$118.57$64.31RVU14A
2013-10-01$120.69$62.41RVU13D
2013-07-01$120.69$62.41RVU13C
2013-04-01$120.69$62.41RVU13B
2013-01-01$120.69$62.41RVU13AR

Price 92311 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

92311 billing questions

When should 92311 be used instead of 92312?

Use 92311 when the fitting is for one aphakic eye. Use 92312 when both aphakic eyes are fitted; do not report two units of 92311 for that bilateral fitting.

How should the record identify the eye?

Document which eye is aphakic and being fitted, along with the fitting work and selected lens characteristics. The code represents one eye.

Is this the code for fitting a contact lens in a nonaphakic eye?

No. For a standard corneal contact lens fitting in an eye without aphakia, consider 92310; 92311 is specific to aphakia in one eye.

Does 92311 describe lens modification or replacement?

No. Code 92325 describes modification of an existing contact lens, while 92326 describes replacement; 92311 is for the aphakic fitting service.

How does 92311 differ from 92315?

Both concern fitting for aphakia in one eye. 92315 is the technician-performed fitting code; 92311 describes the fitting service with medical oversight of adaptation.

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 92311PPRRVU2026_Oct_nonQPP.csv, line 11,755 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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