CPT code 92311: Contact lens fitting, aphakia, one eye2026 Medicare rate & RVUs in New Mexico

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 New Mexico, Medicare pays $93.67 for 92311 in the office and $41.60 when it’s performed in a hospital or facility.

$93.67Office (non-facility)
$41.60Hospital or facility
−5.3%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 New Mexico
  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 New Mexico 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. New Mexico pays $93.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

92311 in New Mexico vs other payment areas
  1. New Mexico · this page$93.67
  2. Los Angeles, CA · California$111.81+$18.14
  3. Washington, DC area · District of Columbia$112.09+$18.42
  4. Miami, FL · Florida$101.98+$8.31
  5. Chicago, IL · Illinois$99.86+$6.19
  6. Manhattan, NY · New York$111.59+$17.92
  7. Alaska · Alaska$120.38+$26.71

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

Every other payment area

92311 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$90.79$41.11
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

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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 92311 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.05× 1.0001.0500
Practice expense1.90× 0.9171.7423
Malpractice0.01× 1.2010.0120
Total RVUs2.8043
Conversion factor× 33.4009

Office rate, New Mexico$93.67

Office: (1.05 × 1 + 1.9 × 0.917 + 0.01 × 1.201) × $33.4009 = $93.67

Facility: (1.05 × 1 + 0.2 × 0.917 + 0.01 × 1.201) × $33.4009 = $41.60

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 New Mexico

92311 · Office / nonfacility

$93.67

Effective 2026-10-01

The base rate is $0.79 higher than on 2025-10-01, moving from $92.88 to $93.67 (0.9%).

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

    $92.88changed to$93.67

    • 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
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $96.79changed to$92.88

    • 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

    $95.21changed to$96.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $99.35changed to$95.21

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.04 changed to 2.00
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $101.13changed to$99.35

    • 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
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $101.96changed to$101.13

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $100.47changed to$101.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.85 changed to 2.03
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $101.13changed to$100.47

    • 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
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $99.36changed to$101.13

    • 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

    $97.61changed to$99.36

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.73 changed to 1.77
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $97.26changed to$97.61

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $97.28changed to$97.26

    • 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

    $96.79changed to$97.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $98.67changed to$96.79

    • 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
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $99.92changed to$98.67

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.94 changed to 1.73
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $99.92

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$93.67$41.60RVU26D
2026-07-01$93.67$41.60RVU26C
2026-04-01$93.67$41.60RVU26B
2026-01-01$93.67$41.60RVU26A
2025-10-01$92.88$47.36RVU25D
2025-07-01$92.88$47.36RVU25C
2025-04-01$92.88$47.36RVU25B
2025-01-01$92.88$47.36RVU25A
2024-10-01$96.79$49.04RVU24D
2024-07-01$96.79$49.04RVU24C
2024-04-01$96.79$49.04RVU24B
2024-03-09$96.79$49.04RVU24AR
2024-01-01$95.21$48.23RVU24A
2023-10-01$99.35$50.44RVU23D
2023-07-01$99.35$50.44RVU23C
2023-04-01$99.35$50.44RVU23B
2023-01-01$99.35$50.44RVU23A
2022-10-01$101.13$51.51RVU22D
2022-07-01$101.13$51.51RVU22C
2022-04-01$101.13$51.51RVU22B
2022-01-01$101.13$51.51RVU22A
2021-10-01$101.96$52.57RVU21D
2021-07-01$101.96$52.57RVU21C
2021-04-01$101.96$52.57RVU21B
2021-01-01$101.96$52.57RVU21A
2020-10-01$100.47$54.27RVU20D
2020-07-01$100.47$54.27RVU20C
2020-04-01$100.47$54.27RVU20B
2020-01-01$100.47$54.27RVU20A
2019-10-01$101.13$55.66RVU19D
2019-07-01$101.13$55.66RVU19C
2019-04-01$101.13$55.66RVU19B
2019-01-01$101.13$55.66RVU19A
2018-10-01$99.36$55.60RVU18D
2018-07-01$99.36$55.60RVU18C
2018-04-01$99.36$55.60RVU18B
2018-01-01$99.36$55.60RVU18AR1
2017-10-01$97.61$55.68RVU17D
2017-07-01$97.61$55.68RVU17C
2017-04-01$97.61$55.68RVU17B
2017-01-01$97.61$55.68RVU17A
2016-10-01$97.26$55.47RVU16D
2016-07-01$97.26$55.47RVU16C
2016-04-01$97.26$55.47RVU16B
2016-01-01$97.26$55.47RVU16A
2015-10-01$97.28$55.34RVU15D
2015-07-01$97.28$55.34RVU15C
2015-04-01$96.79$55.06RVU15B
2015-01-01$96.79$55.06RVU15A
2014-10-01$98.67$57.24RVU14D
2014-07-01$98.67$57.24RVU14C
2014-04-01$98.67$57.24RVU14B
2014-01-01$98.67$57.24RVU14A
2013-10-01$99.92$55.35RVU13D
2013-07-01$99.92$55.35RVU13C
2013-04-01$99.92$55.35RVU13B
2013-01-01$99.92$55.35RVU13AR

Price 92311 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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 New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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