CPT code 92313: Contact lens fitting, corneoscleral lens2026 Medicare rate & RVUs in Queens, NY

Clinician-directed corneoscleral lens fitting with supervised adaptation, commonly used when corneal shape or the ocular surface makes a standard corneal lens unsuitable.

CMS RVU26DEffective Oct 1, 2026One payment locality1.4K Medicare services in 2024

In Queens, NY, Medicare pays $109.45 for 92313 in the office and $38.78 when it’s performed in a hospital or facility.

$109.45Office (non-facility)
$38.78Hospital or facility
+14.6%vs the national office rate ($95.53)

Check a contract rate as a % of Medicare · 92313 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 92313 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 92313 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 92313 covers

Code 92313 describes a clinician-directed fitting of a corneoscleral contact lens, which vaults the cornea and bears on the sclera. An ophthalmologist or optometrist typically evaluates the eye, selects and assesses trial lenses, and supervises adaptation. This approach is often considered for irregular corneas, such as with keratoconus or after corneal transplantation, and for some ocular-surface conditions. Fitting may include evaluating lens position and clearance, vision, comfort, and the patient’s ability to handle the lens.

Choose this code for the corneoscleral lens service, rather than a standard corneal lens fitting or a technician-performed fitting. Documentation should support the lens type, clinical fitting work, assessment of the trial lens, and the clinician’s supervision of adaptation. The contact lens product is distinct from the fitting service and should be handled separately when reportable. CMS valuation uses work and practice-expense inputs, with practice expense valued differently for 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 Queens, NY compares for 92313

Across 109 of 109 payment localities, the office rate for 92313 runs from $86.18 in Arkansas to $127.47 in San Benito County, CA. Queens, NY pays $109.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

92313 in Queens, NY vs other payment areas
  1. Queens, NY · this page$109.45
  2. Manhattan, NY · New York$108.20−$1.25
  3. NYC suburbs and Long Island, NY · New York$110.05+$0.60
  4. Rest of New York · New York$92.17−$17.28
  5. Los Angeles, CA · California$108.57−$0.88
  6. Washington, DC area · District of Columbia$108.78−$0.67

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

Every other payment area

92313 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$98.71$36.47
Chicago, ILIllinois$96.50$36.41
AlaskaAlaska$114.64$50.97
AlabamaAlabama$87.24$34.93
ArkansasArkansas$86.18$34.82
ArizonaArizona$93.46$35.53
Bakersfield, CACalifornia$102.22$36.69
Chico, CACalifornia$102.14$36.61

92313 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.

$86.18

$114.81

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

View every state and territory as a table
92313 office rate range by state
State / territoryOffice rate rangeLocalities
AK$114.641
AL$87.241
AR$86.181
AZ$93.461
CA$102.14–$127.4729
CO$99.981
CT$101.211
DC$108.781
DE$94.861
FL$92.83–$98.713
GA$88.56–$96.732
GU$104.311
HI$104.311
IA$89.791
ID$90.141
IL$90.05–$97.754
IN$90.601
KS$89.111
KY$88.271
LA$88.02–$91.732
MA$99.39–$109.362
MD$96.58–$108.783
ME$90.19–$94.822
MI$89.90–$93.482
MN$97.181
MO$86.53–$92.403
MS$86.391
MT$95.531
NC$91.041
ND$95.331
NE$90.301
NH$98.161
NJ$102.75–$107.862
NM$90.191
NV$95.541
NY$92.17–$110.055
OH$89.861
OK$88.481
OR$95.17–$103.152
PA$90.17–$98.802
PR$96.241
RI$98.211
SC$90.531
SD$95.301
TN$89.441
TX$89.64–$99.338
UT$91.581
VA$94.32–$108.782
VI$96.241
VT$94.711
WA$99.29–$111.752
WI$92.561
WV$87.141
WY$95.441

See 92313 in every payment locality

How the 92313 rate is calculated

Each of 92313’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 · 92313

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.90

0.90 RVUs× 1.000 GPCI

Practice expense1.95

1.95 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

2.8600

Conversion factor

$33.4009

Medicare rate

$95.53

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

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,757

Code
92313
Physician work
0.90
Practice expense
1.95
Malpractice
0.01

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 92313 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.90× 1.0640.9576
Practice expense1.95× 1.1822.3049
Malpractice0.01× 1.4420.0144
Total RVUs3.2769
Conversion factor× 33.4009

Office rate, Queens, NY$109.45

Office: (0.9 × 1.064 + 1.95 × 1.182 + 0.01 × 1.442) × $33.4009 = $109.45

Facility: (0.9 × 1.064 + 0.16 × 1.182 + 0.01 × 1.442) × $33.4009 = $38.78

Open 92313 in the RVU calculator

Payment rules and modifiers for 92313

92313 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 · 92313

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$95.53

Non-facility (office)
$95.53
Facility
$35.74

Higher because the practice carries its own overhead.

How 92313 has changed in Queens, NY

92313 · Office / nonfacility

$109.45

Effective 2026-10-01

The base rate is $0.36 higher than on 2025-10-01, moving from $109.09 to $109.45 (0.3%).

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

    $109.09changed to$109.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.92 changed to 0.90
    • Practice expense RVU 1.99 changed to 1.95
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $113.06changed to$109.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.01 changed to 1.99

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $111.21changed to$113.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $117.56changed to$111.21

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.04 changed to 2.01
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462
  5. January 1, 2023

    RVU23A

    $120.81changed to$117.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.03 changed to 2.04
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.38changed to$120.81

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.02 changed to 2.03

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $116.47changed to$121.38

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.84 changed to 2.02
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $116.32changed to$116.47

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.83 changed to 1.84
    • Malpractice RVU 0.03 changed to 0.01
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $114.46changed to$116.32

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.79 changed to 1.83

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $113.28changed to$114.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.77 changed to 1.79
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $113.41changed to$113.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.78 changed to 1.77
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $114.25changed to$113.41

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.79 changed to 1.78

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $113.68changed to$114.25

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $115.31changed to$113.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.80 changed to 1.79
    • Malpractice RVU 0.05 changed to 0.03
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $120.75changed to$115.31

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.09 changed to 1.80
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $120.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$109.45$38.78RVU26D
2026-07-01$109.45$38.78RVU26C
2026-04-01$109.45$38.78RVU26B
2026-01-01$109.45$38.78RVU26A
2025-10-01$109.09$45.31RVU25D
2025-07-01$109.09$45.31RVU25C
2025-04-01$109.09$45.31RVU25B
2025-01-01$109.09$45.31RVU25A
2024-10-01$113.06$46.23RVU24D
2024-07-01$113.06$46.23RVU24C
2024-04-01$113.06$46.23RVU24B
2024-03-09$113.06$46.23RVU24AR
2024-01-01$111.21$45.47RVU24A
2023-10-01$117.56$47.74RVU23D
2023-07-01$117.56$47.74RVU23C
2023-04-01$117.56$47.74RVU23B
2023-01-01$117.56$47.74RVU23A
2022-10-01$120.81$48.57RVU22D
2022-07-01$120.81$48.57RVU22C
2022-04-01$120.81$48.57RVU22B
2022-01-01$120.81$48.57RVU22A
2021-10-01$121.38$49.40RVU21D
2021-07-01$121.38$49.40RVU21C
2021-04-01$121.38$49.40RVU21B
2021-01-01$121.38$49.40RVU21A
2020-10-01$116.47$50.75RVU20D
2020-07-01$116.47$50.75RVU20C
2020-04-01$116.47$50.75RVU20B
2020-01-01$116.47$50.75RVU20A
2019-10-01$116.32$52.74RVU19D
2019-07-01$116.32$52.74RVU19C
2019-04-01$116.32$52.74RVU19B
2019-01-01$116.32$52.74RVU19A
2018-10-01$114.46$53.12RVU18D
2018-07-01$114.46$53.12RVU18C
2018-04-01$114.46$53.12RVU18B
2018-01-01$114.46$53.12RVU18AR1
2017-10-01$113.28$53.85RVU17D
2017-07-01$113.28$53.85RVU17C
2017-04-01$113.28$53.85RVU17B
2017-01-01$113.28$53.85RVU17A
2016-10-01$113.41$53.74RVU16D
2016-07-01$113.41$53.74RVU16C
2016-04-01$113.41$53.74RVU16B
2016-01-01$113.41$53.74RVU16A
2015-10-01$114.25$53.93RVU15D
2015-07-01$114.25$53.93RVU15C
2015-04-01$113.68$53.66RVU15B
2015-01-01$113.68$53.66RVU15A
2014-10-01$115.31$56.13RVU14D
2014-07-01$115.31$56.13RVU14C
2014-04-01$115.31$56.13RVU14B
2014-01-01$115.31$56.13RVU14A
2013-10-01$120.75$56.11RVU13D
2013-07-01$120.75$56.11RVU13C
2013-04-01$120.75$56.11RVU13B
2013-01-01$120.75$56.11RVU13AR

Price 92313 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

92313 billing questions

How is 92313 different from 92310?

92313 is for a corneoscleral lens fitting. 92310 is used for the specified standard corneal lens fitting, not the corneoscleral lens service.

Can a technician-performed corneoscleral fitting be reported with 92313?

92313 describes clinician-directed fitting with medical supervision of adaptation. Code 92317 is the technician fitting counterpart; select the code that matches who performed the service.

Does 92313 include the contact lens itself?

The code describes the fitting and supervised adaptation service, not the lens product. Handle the lens separately when it is independently reportable.

What documentation supports 92313?

Record why a corneoscleral lens was selected, the trial-lens assessment and fitting work, and the clinician’s role in supervising adaptation.

Does the code identify one eye or both eyes?

The code identifies a corneoscleral lens fitting and does not specify an eye in its descriptor. Follow current CPT reporting instructions for units and document the service performed.

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 92313PPRRVU2026_Oct_nonQPP.csv, line 11,757 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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