CPT code 92311: Contact lens fitting, aphakia, one eye2026 Medicare rate & RVUs in South Dakota
Reports the clinical fitting of a contact lens for one aphakic eye, including lens selection, fit assessment, and medical oversight during adaptation.
In South Dakota, Medicare pays $98.64 for 92311 in the office and $41.86 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $98.64. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$98.64
- Los Angeles, CA · California$111.81+$13.17
- Washington, DC area · District of Columbia$112.09+$13.45
- Miami, FL · Florida$101.98+$3.34
- Chicago, IL · Illinois$99.86+$1.22
- Manhattan, NY · New York$111.59+$12.95
- Alaska · Alaska$120.38+$21.74
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $105.40 | $43.17 |
| Merced, CACalifornia | $105.40 | $43.17 |
| Modesto, CACalifornia | $105.40 | $43.17 |
| Napa, CACalifornia | $121.09 | $46.25 |
| Oxnard, CACalifornia | $111.27 | $44.16 |
| Redding, CACalifornia | $105.40 | $43.17 |
| Rest of CaliforniaCalifornia | $105.40 | $43.17 |
| Riverside, CACalifornia | $105.54 | $43.31 |
| Sacramento, CACalifornia | $110.32 | $44.28 |
| Salinas, CACalifornia | $109.89 | $44.08 |
| San Diego, CACalifornia | $112.20 | $44.29 |
| Marin County, CACalifornia | $128.04 | $47.98 |
| San Francisco, CACalifornia | $128.03 | $47.96 |
| San Benito County, CACalifornia | $130.62 | $48.74 |
| Santa Clara County, CACalifornia | $130.57 | $48.69 |
| San Luis Obispo, CACalifornia | $108.13 | $43.45 |
| Santa Cruz, CACalifornia | $113.09 | $44.10 |
| Santa Maria, CACalifornia | $110.23 | $44.02 |
| Santa Rosa, CACalifornia | $114.23 | $44.51 |
| Stockton, CACalifornia | $105.40 | $43.17 |
| Vallejo, CACalifornia | $121.08 | $46.24 |
| Visalia, CACalifornia | $105.40 | $43.17 |
| Yuba City, CACalifornia | $105.40 | $43.17 |
| ColoradoColorado | $103.28 | $42.86 |
| ConnecticutConnecticut | $104.52 | $43.37 |
| DelawareDelaware | $98.25 | $42.15 |
| Fort Lauderdale, FLFlorida | $99.96 | $42.44 |
| Rest of FloridaFlorida | $96.24 | $41.96 |
| Atlanta, GAGeorgia | $100.05 | $42.36 |
| Rest of GeorgiaGeorgia | $92.08 | $41.43 |
| Hawaii, Guam, HIHawaii | $107.42 | $42.86 |
| IowaIowa | $93.27 | $41.32 |
| IdahoIdaho | $93.61 | $41.37 |
| East St. Louis, ILIllinois | $94.13 | $41.89 |
| Rest of IllinoisIllinois | $93.53 | $41.69 |
| Suburban Chicago, ILIllinois | $101.08 | $42.77 |
| IndianaIndiana | $94.06 | $41.43 |
| KansasKansas | $92.61 | $41.28 |
| KentuckyKentucky | $91.79 | $41.32 |
| New Orleans, LALouisiana | $95.17 | $41.74 |
| Rest of LouisianaLouisiana | $91.55 | $41.30 |
| Metropolitan Boston, MAMassachusetts | $112.58 | $44.78 |
| Rest of MassachusettsMassachusetts | $102.72 | $42.93 |
| Baltimore area, MDMaryland | $104.14 | $43.21 |
| Rest of MarylandMaryland | $99.95 | $42.49 |
| Rest of MaineMaine | $93.66 | $41.42 |
| Southern Maine, MEMaine | $98.17 | $41.90 |
| Detroit, MIMichigan | $96.87 | $42.08 |
| Rest of MichiganMichigan | $93.39 | $41.55 |
| MinnesotaMinnesota | $100.47 | $42.04 |
| Metropolitan Kansas City, MOMissouri | $94.99 | $41.67 |
| Metropolitan St. Louis, MOMissouri | $95.82 | $41.77 |
| Rest of MissouriMissouri | $90.10 | $41.15 |
| MississippiMississippi | $89.96 | $41.07 |
| MontanaMontana | $98.87 | $42.08 |
| North CarolinaNorth Carolina | $94.49 | $41.52 |
| North DakotaNorth Dakota | $98.67 | $41.89 |
| NebraskaNebraska | $93.77 | $41.36 |
| New HampshireNew Hampshire | $101.43 | $42.32 |
| Northern New JerseyNew Jersey | $111.25 | $45.39 |
| Rest of New JerseyNew Jersey | $106.14 | $44.13 |
| New MexicoNew Mexico | $93.67 | $41.60 |
| NevadaNevada | $98.87 | $42.04 |
| NYC suburbs and Long Island, NYNew York | $113.39 | $45.88 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $106.54 | $44.37 |
| Queens, NYNew York | $112.81 | $45.69 |
| Rest of New YorkNew York | $95.59 | $41.65 |
| OhioOhio | $93.35 | $41.51 |
| OklahomaOklahoma | $92.00 | $41.30 |
| Portland, OROregon | $106.39 | $43.30 |
| Rest of OregonOregon | $98.51 | $41.96 |
| Metropolitan Philadelphia, PAPennsylvania | $102.16 | $43.05 |
| Rest of PennsylvaniaPennsylvania | $93.64 | $41.52 |
| Puerto RicoPuerto Rico | $99.56 | $42.15 |
| Rhode IslandRhode Island | $101.59 | $42.94 |
| South CarolinaSouth Carolina | $93.99 | $41.53 |
| TennesseeTennessee | $92.94 | $41.32 |
| Austin, TXTexas | $102.58 | $42.50 |
| Beaumont, TXTexas | $93.13 | $41.46 |
| Brazoria, TXTexas | $98.50 | $42.23 |
| Dallas, TXTexas | $98.88 | $42.33 |
| Fort Worth, TXTexas | $98.25 | $42.26 |
| Galveston, TXTexas | $98.65 | $42.26 |
| Houston, TXTexas | $98.83 | $42.44 |
| Rest of TexasTexas | $95.60 | $41.71 |
| UtahUtah | $95.02 | $41.65 |
| VirginiaVirginia | $97.69 | $41.87 |
| Virgin Islands, VIUnited States Virgin Islands | $99.56 | $42.15 |
| VermontVermont | $98.07 | $41.85 |
| Rest of WashingtonWashington | $102.61 | $42.82 |
| King County, WAWashington | $114.96 | $45.29 |
| WisconsinWisconsin | $95.97 | $41.57 |
| West VirginiaWest Virginia | $90.70 | $41.35 |
| WyomingWyoming | $98.78 | $42.00 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $120.38 | 1 |
| AL | $90.79 | 1 |
| AR | $89.76 | 1 |
| AZ | $96.85 | 1 |
| CA | $105.40–$130.62 | 29 |
| CO | $103.28 | 1 |
| CT | $104.52 | 1 |
| DC | $112.09 | 1 |
| DE | $98.25 | 1 |
| FL | $96.24–$101.98 | 3 |
| GA | $92.08–$100.05 | 2 |
| GU | $107.42 | 1 |
| HI | $107.42 | 1 |
| IA | $93.27 | 1 |
| ID | $93.61 | 1 |
| IL | $93.53–$101.08 | 4 |
| IN | $94.06 | 1 |
| KS | $92.61 | 1 |
| KY | $91.79 | 1 |
| LA | $91.55–$95.17 | 2 |
| MA | $102.72–$112.58 | 2 |
| MD | $99.95–$112.09 | 3 |
| ME | $93.66–$98.17 | 2 |
| MI | $93.39–$96.87 | 2 |
| MN | $100.47 | 1 |
| MO | $90.10–$95.82 | 3 |
| MS | $89.96 | 1 |
| MT | $98.87 | 1 |
| NC | $94.49 | 1 |
| ND | $98.67 | 1 |
| NE | $93.77 | 1 |
| NH | $101.43 | 1 |
| NJ | $106.14–$111.25 | 2 |
| NM | $93.67 | 1 |
| NV | $98.87 | 1 |
| NY | $95.59–$113.39 | 5 |
| OH | $93.35 | 1 |
| OK | $92.00 | 1 |
| OR | $98.51–$106.39 | 2 |
| PA | $93.64–$102.16 | 2 |
| PR | $99.56 | 1 |
| RI | $101.59 | 1 |
| SC | $93.99 | 1 |
| SD | $98.64 | 1 |
| TN | $92.94 | 1 |
| TX | $93.13–$102.58 | 8 |
| UT | $95.02 | 1 |
| VA | $97.69–$112.09 | 2 |
| VI | $99.56 | 1 |
| VT | $98.07 | 1 |
| WA | $102.61–$114.96 | 2 |
| WI | $95.97 | 1 |
| WV | $90.70 | 1 |
| WY | $98.78 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.05 | × 1.000 | 1.0500 |
| Practice expense | 1.90 | × 1.000 | 1.9000 |
| Malpractice | 0.01 | × 0.336 | 0.0034 |
| Total RVUs | 2.9534 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$98.64
Office: (1.05 × 1 + 1.9 × 1 + 0.01 × 0.336) × $33.4009 = $98.64
Facility: (1.05 × 1 + 0.2 × 1 + 0.01 × 0.336) × $33.4009 = $41.86
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 South Dakota
92311 · Office / nonfacility
$98.64
Effective 2026-10-01
The base rate is $0.18 higher than on 2025-10-01, moving from $98.46 to $98.64 (0.2%).
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
$98.46changed to$98.64
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$102.65changed to$98.46
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.00 changed to 1.96
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$100.98changed to$102.65
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$105.85changed to$100.98
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.04 changed to 2.00
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$107.87changed to$105.85
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$108.76changed to$107.87
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$106.01changed to$108.76
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.85 changed to 2.03
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$105.07changed to$106.01
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$103.16changed to$105.07
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.77 changed to 1.82
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$101.41changed to$103.16
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.73 changed to 1.77
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$101.18changed to$101.41
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$101.19changed to$101.18
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.72 changed to 1.73
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$100.69changed to$101.19
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$101.85changed to$100.69
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$103.93changed to$101.85
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.94 changed to 1.73
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $103.93
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $98.64 | $41.86 | RVU26D |
| 2026-07-01 | $98.64 | $41.86 | RVU26C |
| 2026-04-01 | $98.64 | $41.86 | RVU26B |
| 2026-01-01 | $98.64 | $41.86 | RVU26A |
| 2025-10-01 | $98.46 | $48.32 | RVU25D |
| 2025-07-01 | $98.46 | $48.32 | RVU25C |
| 2025-04-01 | $98.46 | $48.32 | RVU25B |
| 2025-01-01 | $98.46 | $48.32 | RVU25A |
| 2024-10-01 | $102.65 | $50.06 | RVU24D |
| 2024-07-01 | $102.65 | $50.06 | RVU24C |
| 2024-04-01 | $102.65 | $50.06 | RVU24B |
| 2024-03-09 | $102.65 | $50.06 | RVU24AR |
| 2024-01-01 | $100.98 | $49.24 | RVU24A |
| 2023-10-01 | $105.85 | $51.63 | RVU23D |
| 2023-07-01 | $105.85 | $51.63 | RVU23C |
| 2023-04-01 | $105.85 | $51.63 | RVU23B |
| 2023-01-01 | $105.85 | $51.63 | RVU23A |
| 2022-10-01 | $107.87 | $52.50 | RVU22D |
| 2022-07-01 | $107.87 | $52.50 | RVU22C |
| 2022-04-01 | $107.87 | $52.50 | RVU22B |
| 2022-01-01 | $107.87 | $52.50 | RVU22A |
| 2021-10-01 | $108.76 | $53.63 | RVU21D |
| 2021-07-01 | $108.76 | $53.63 | RVU21C |
| 2021-04-01 | $108.76 | $53.63 | RVU21B |
| 2021-01-01 | $108.76 | $53.63 | RVU21A |
| 2020-10-01 | $106.01 | $55.12 | RVU20D |
| 2020-07-01 | $106.01 | $55.12 | RVU20C |
| 2020-04-01 | $106.01 | $55.12 | RVU20B |
| 2020-01-01 | $106.01 | $55.12 | RVU20A |
| 2019-10-01 | $105.07 | $55.70 | RVU19D |
| 2019-07-01 | $105.07 | $55.70 | RVU19C |
| 2019-04-01 | $105.07 | $55.70 | RVU19B |
| 2019-01-01 | $105.07 | $55.70 | RVU19A |
| 2018-10-01 | $103.16 | $55.64 | RVU18D |
| 2018-07-01 | $103.16 | $55.64 | RVU18C |
| 2018-04-01 | $103.16 | $55.64 | RVU18B |
| 2018-01-01 | $103.16 | $55.64 | RVU18AR1 |
| 2017-10-01 | $101.41 | $55.84 | RVU17D |
| 2017-07-01 | $101.41 | $55.84 | RVU17C |
| 2017-04-01 | $101.41 | $55.84 | RVU17B |
| 2017-01-01 | $101.41 | $55.84 | RVU17A |
| 2016-10-01 | $101.18 | $55.71 | RVU16D |
| 2016-07-01 | $101.18 | $55.71 | RVU16C |
| 2016-04-01 | $101.18 | $55.71 | RVU16B |
| 2016-01-01 | $101.18 | $55.71 | RVU16A |
| 2015-10-01 | $101.19 | $55.55 | RVU15D |
| 2015-07-01 | $101.19 | $55.55 | RVU15C |
| 2015-04-01 | $100.69 | $55.28 | RVU15B |
| 2015-01-01 | $100.69 | $55.28 | RVU15A |
| 2014-10-01 | $101.85 | $56.72 | RVU14D |
| 2014-07-01 | $101.85 | $56.72 | RVU14C |
| 2014-04-01 | $101.85 | $56.72 | RVU14B |
| 2014-01-01 | $101.85 | $56.72 | RVU14A |
| 2013-10-01 | $103.93 | $55.27 | RVU13D |
| 2013-07-01 | $103.93 | $55.27 | RVU13C |
| 2013-04-01 | $103.93 | $55.27 | RVU13B |
| 2013-01-01 | $103.93 | $55.27 | 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
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
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