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CPT code 92316: Contact lens fitting, technician, aphakia, both eyes2026 Medicare rate & RVUs in Chicago, IL

Reports technician-performed contact lens fitting for aphakia in both eyes, including assessment and selection of lenses to address the absence of natural lenses.

CMS RVU26DEffective Oct 1, 2026One payment locality30 Medicare services in 2024

In Chicago, IL, Medicare pays $98.83 for 92316 in the office and $26.99 when it’s performed in a hospital or facility.

$98.83Office (non-facility)
$26.99Hospital or facility
+1.0%vs the national office rate ($97.86)

Check a contract rate as a % of Medicare · 92316 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 92316 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chicago, IL
  2. What 92316 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 92316 covers

This service covers fitting contact lenses for a patient with aphakia, meaning the natural crystalline lens is absent, in both eyes. A technician performs the fitting, which may involve assessing lens fit and visual performance and selecting lenses appropriate for the patient’s needs. It is distinct from fitting contact lenses for a patient without aphakia and from fitting a lens for only one aphakic eye.

Report the code when the technician provides the fitting service for both eyes, rather than for dispensing an already-fitted lens alone. The record should support aphakia in both eyes and document the fitting work performed. CMS prices this code as bilateral: report the service for both eyes under this code, and modifier 50 does not increase payment.

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 Chicago, IL compares for 92316

Across 109 of 109 payment localities, the office rate for 92316 runs from $87.06 in Arkansas to $133.50 in San Benito County, CA. Chicago, IL pays $98.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

92316 in Chicago, IL vs other payment areas
  1. Chicago, IL · this page$98.83
  2. East St. Louis, IL · Illinois$92.16−$6.67
  3. Rest of Illinois · Illinois$91.49−$7.34
  4. Suburban Chicago, IL · Illinois$100.31+$1.48
  5. Los Angeles, CA · California$112.47+$13.64
  6. Washington, DC area · District of Columbia$112.53+$13.70
  7. Miami, FL · Florida$101.47+$2.64

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

Every other payment area

92316 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$111.70$28.64
AlaskaAlaska$113.64$37.52
AlabamaAlabama$88.28$25.74
ArkansasArkansas$87.06$25.66
ArizonaArizona$95.48$26.21
Bakersfield, CACalifornia$105.40$27.06
Chico, CACalifornia$105.33$26.99
El Centro, CACalifornia$105.33$26.99

92316 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$87.06

$119.41

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

View every state and territory as a table
92316 office rate range by state
State / territoryOffice rate rangeLocalities
AK$113.641
AL$88.281
AR$87.061
AZ$95.481
CA$105.33–$133.5029
CO$102.891
CT$104.191
DC$112.531
DE$97.041
FL$94.71–$101.473
GA$89.78–$99.212
GU$108.071
HI$108.071
IA$91.251
ID$91.651
IL$91.49–$100.314
IN$92.181
KS$90.451
KY$89.461
LA$89.17–$93.462
MA$102.15–$113.382
MD$98.96–$112.533
ME$91.70–$97.062
MI$91.34–$95.452
MN$99.821
MO$87.44–$94.243
MS$87.281
MT$97.861
NC$92.691
ND$97.671
NE$91.841
NH$100.921
NJ$105.72–$111.352
NM$91.671
NV$97.881
NY$93.99–$113.835
OH$91.301
OK$89.711
OR$97.46–$106.512
PA$91.66–$101.422
PR$98.691
RI$100.741
SC$92.081
SD$97.641
TN$90.841
TX$91.05–$102.258
UT$93.301
VA$96.48–$112.532
VI$98.691
VT$96.941
WA$102.07–$116.042
WI$94.461
WV$88.121
WY$97.781

See 92316 in every payment locality

How the 92316 rate is calculated

Each of 92316’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 · 92316

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.66

0.66 RVUs× 1.000 GPCI

Practice expense2.26

2.26 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

2.9300

Conversion factor

$33.4009

Medicare rate

$97.86

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

The exact Chicago, IL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,760

Code
92316
Physician work
0.66
Practice expense
2.26
Malpractice
0.01

GPCI2026.csv

48

Locality
Chicago, IL
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office calculation for 92316 in Chicago, IL
ComponentRVULocality factorAdjusted
Physician work0.66× 1.0070.6646
Practice expense2.26× 1.0052.2713
Malpractice0.01× 2.2950.0229
Total RVUs2.9589
Conversion factor× 33.4009

Office rate, Chicago, IL$98.83

Office: (0.66 × 1.007 + 2.26 × 1.005 + 0.01 × 2.295) × $33.4009 = $98.83

Facility: (0.66 × 1.007 + 0.12 × 1.005 + 0.01 × 2.295) × $33.4009 = $26.99

Open 92316 in the RVU calculator

Payment rules and modifiers for 92316

The CMS indicators that decide how 92316 is paid alongside other services.

CMS payment indicators · 92316

Contact lens fitting, technician, aphakia, both eyes

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.

Codes related to 92316

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 92316
CodeHow it relatesOffice range, Chicago, IL
Same family
92312Contact lens fitting, aphakia, both eyesBilateral aphakia fitting; distinguishes the fitting service from the technician-designated code.$114.31
92315Contact lens fitting, technician, one aphakic eyeTechnician fitting for aphakia in one eye rather than both.$80.02
Used instead
92314Contact lens fitting, technician, both eyesTechnician fitting for both eyes when the patient does not have aphakia.No office rate
92313Contact lens fitting, corneoscleral lensFitting for a corneoscleral lens, a different lens type.$96.50

How 92316 has changed in Chicago, IL

92316 · Office / nonfacility

$98.83

Effective 2026-10-01

The base rate is $0.41 lower than on 2025-10-01, moving from $99.24 to $98.83 (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

    $99.24changed to$98.83

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.68 changed to 0.66
    • Practice expense RVU 2.31 changed to 2.26
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $103.15changed to$99.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.34 changed to 2.31

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $101.47changed to$103.15

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $106.17changed to$101.47

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.35 changed to 2.34
    • Work GPCI 1.009 changed to 1.007
    • Practice expense GPCI 1.033 changed to 1.023
    • Malpractice GPCI 1.945 changed to 2.018

  5. January 1, 2023

    RVU23A

    $108.26changed to$106.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.32 changed to 2.35
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 1.871 changed to 1.945

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $108.06changed to$108.26

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.29 changed to 2.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $103.07changed to$108.06

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.07 changed to 2.29
    • Work GPCI 1.009 changed to 1.011
    • Practice expense GPCI 1.039 changed to 1.044
    • Malpractice GPCI 1.898 changed to 1.871

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $101.36changed to$103.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.02 changed to 2.07
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.008 changed to 1.009
    • Practice expense GPCI 1.034 changed to 1.039
    • Malpractice GPCI 1.925 changed to 1.898

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $99.02changed to$101.36

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.96 changed to 2.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $97.50changed to$99.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.92 changed to 1.96
    • Work GPCI 1.012 changed to 1.008
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 1.972 changed to 1.925

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $95.98changed to$97.50

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.88 changed to 1.92
    • Work GPCI 1.016 changed to 1.012
    • Practice expense GPCI 1.037 changed to 1.036
    • Malpractice GPCI 2.019 changed to 1.972

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $96.33changed to$95.98

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $95.85changed to$96.33

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $97.42changed to$95.85

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.86 changed to 1.88
    • Malpractice RVU 0.04 changed to 0.02
    • Work GPCI 1.023 changed to 1.016
    • Practice expense GPCI 1.044 changed to 1.037
    • Malpractice GPCI 2.048 changed to 2.019

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $118.55changed to$97.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.57 changed to 1.86
    • Work GPCI 1.030 changed to 1.023
    • Practice expense GPCI 1.051 changed to 1.044
    • Malpractice GPCI 2.077 changed to 2.048

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$118.55

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$98.83$26.99RVU26D
2026-07-01$98.83$26.99RVU26C
2026-04-01$98.83$26.99RVU26B
2026-01-01$98.83$26.99RVU26A
2025-10-01$99.24$30.74RVU25D
2025-07-01$99.24$30.74RVU25C
2025-04-01$99.24$30.74RVU25B
2025-01-01$99.24$30.74RVU25A
2024-10-01$103.15$31.30RVU24D
2024-07-01$103.15$31.30RVU24C
2024-04-01$103.15$31.30RVU24B
2024-03-09$103.15$31.30RVU24AR
2024-01-01$101.47$30.79RVU24A
2023-10-01$106.17$32.31RVU23D
2023-07-01$106.17$32.31RVU23C
2023-04-01$106.17$32.31RVU23B
2023-01-01$106.17$32.31RVU23A
2022-10-01$108.26$32.75RVU22D
2022-07-01$108.26$32.75RVU22C
2022-04-01$108.26$32.75RVU22B
2022-01-01$108.26$32.75RVU22A
2021-10-01$108.06$33.02RVU21D
2021-07-01$108.06$33.02RVU21C
2021-04-01$108.06$33.02RVU21B
2021-01-01$108.06$33.02RVU21A
2020-10-01$103.07$34.07RVU20D
2020-07-01$103.07$34.07RVU20C
2020-04-01$103.07$34.07RVU20B
2020-01-01$103.07$34.07RVU20A
2019-10-01$101.36$34.66RVU19D
2019-07-01$101.36$34.66RVU19C
2019-04-01$101.36$34.66RVU19B
2019-01-01$101.36$34.66RVU19A
2018-10-01$99.02$35.00RVU18D
2018-07-01$99.02$35.00RVU18C
2018-04-01$99.02$35.00RVU18B
2018-01-01$99.02$35.00RVU18AR1
2017-10-01$97.50$35.04RVU17D
2017-07-01$97.50$35.04RVU17C
2017-04-01$97.50$35.04RVU17B
2017-01-01$97.50$35.04RVU17A
2016-10-01$95.98$34.72RVU16D
2016-07-01$95.98$34.72RVU16C
2016-04-01$95.98$34.72RVU16B
2016-01-01$95.98$34.72RVU16A
2015-10-01$96.33$34.85RVU15D
2015-07-01$96.33$34.85RVU15C
2015-04-01$95.85$34.67RVU15B
2015-01-01$95.85$34.67RVU15A
2014-10-01$97.42$36.83RVU14D
2014-07-01$97.42$36.83RVU14C
2014-04-01$97.42$36.83RVU14B
2014-01-01$97.42$36.83RVU14A
2013-10-01$118.55$43.11RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 92316 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Illinois

92316 billing questions

When should this code be used instead of 92314?

Use 92316 for a technician-performed fitting in a patient with aphakia in both eyes. Code 92314 is for a technician-performed fitting in a patient who does not have aphakia.

Should modifier 50 be appended?

The code is already priced as bilateral, and modifier 50 does not increase payment. It represents fitting for both eyes.

How does this differ from 92312?

Both codes describe contact lens fitting for aphakia in both eyes. Code 92316 identifies the technician-performed service; 92312 is the corresponding fitting code without the technician designation.

What documentation supports reporting this code?

Document aphakia in both eyes and the technician’s fitting work, such as assessment of lens fit or visual performance and lens selection.

Can this code be used for one aphakic eye?

No. This code is for fitting in both eyes. Code 92315 is the technician fitting code for aphakia in one eye.

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 92316PPRRVU2026_Oct_nonQPP.csv, line 11,760 (RVU26D)
Geographic factors for Chicago, ILGPCI2026.csv, line 48 (RVU26D)

Open CMS sourceHow we calculate rates

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