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

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, 20263 payment localities30 Medicare services in 2024

Medicare pays $87.44–$94.24 for 92316 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.

$87.44–$94.24Office (non-facility)
$25.82–$26.19Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Missouri
  2. What 92316 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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.

Where 92316 pays more and less in Missouri

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$87.44 to $94.24

$87.44$90.84$94.24
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
92316 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Kansas City, MO$93.25$26.13
Metropolitan St. Louis, MO$94.24$26.19
Rest of Missouri$87.44$25.82

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.

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.

92316 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 92316

    Contact lens fitting, technician, aphakia, both eyes0.66 wRVU

    $97.86

  • 92312

    Contact lens fitting, aphakia, both eyes1.23 wRVU

    $113.23+$15.37

  • 92315

    Contact lens fitting, technician, one aphakic eye0.44 wRVU

    $79.16−$18.70

  • 92314

    Contact lens fitting, technician, both eyes0.67 wRVU

    Not priced

How to choose

92312Contact lens fittingAphakia, both eyes
Both codes concern fitting contact lenses for aphakia in both eyes. Choose 92316 when the technician designation applies; 92312 is the corresponding code without that designation.
92315Contact lens fittingTechnician, one aphakic eye
Both identify technician-performed contact lens fitting for aphakia. Code 92315 is for one eye; 92316 is for both eyes.
92314Contact lens fittingTechnician, both eyes
Both describe technician-performed fitting for both eyes, but 92316 is for aphakia and 92314 is for fitting without aphakia.

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)

Open CMS sourceHow we calculate rates

Did this answer your question about what 92316 pays in Missouri?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 92316 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist