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

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 South Dakota, Medicare pays $97.64 for 92316 in the office and $26.16 when it’s performed in a hospital or facility.

$97.64Office (non-facility)
$26.16Hospital or facility
−0.2%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 South Dakota
  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 South Dakota 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. South Dakota pays $97.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

92316 in South Dakota vs other payment areas
  1. South Dakota · this page$97.64
  2. Los Angeles, CA · California$112.47+$14.83
  3. Washington, DC area · District of Columbia$112.53+$14.89
  4. Miami, FL · Florida$101.47+$3.83
  5. Chicago, IL · Illinois$98.83+$1.19
  6. Manhattan, NY · New York$111.70+$14.06
  7. Alaska · Alaska$113.64+$16.00

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

Every other payment area

92316 in every other Medicare payment locality
Payment localityOfficeFacility
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
Fresno, CACalifornia$105.33$26.99
Hanford, 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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 92316 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.66× 1.0000.6600
Practice expense2.26× 1.0002.2600
Malpractice0.01× 0.3360.0034
Total RVUs2.9234
Conversion factor× 33.4009

Office rate, South Dakota$97.64

Office: (0.66 × 1 + 2.26 × 1 + 0.01 × 0.336) × $33.4009 = $97.64

Facility: (0.66 × 1 + 0.12 × 1 + 0.01 × 0.336) × $33.4009 = $26.16

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, South Dakota
Same family
92312Contact lens fitting, aphakia, both eyesBilateral aphakia fitting; distinguishes the fitting service from the technician-designated code.$113.01
92315Contact lens fitting, technician, one aphakic eyeTechnician fitting for aphakia in one eye rather than both.$78.94
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.$95.30

How 92316 has changed in South Dakota

92316 · Office / nonfacility

$97.64

Effective 2026-10-01

The base rate is $0.80 higher than on 2025-10-01, moving from $96.84 to $97.64 (0.8%).

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

    $96.84changed to$97.64

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $100.66changed to$96.84

    • 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

    $99.01changed to$100.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $102.80changed to$99.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.35 changed to 2.34
    • Malpractice GPCI 0.364 changed to 0.382

  5. January 1, 2023

    RVU23A

    $103.94changed to$102.80

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.32 changed to 2.35
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $103.75changed to$103.94

    • 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

    $99.38changed to$103.75

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.07 changed to 2.29
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $97.59changed to$99.38

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $95.32changed to$97.59

    • 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

    $93.59changed to$95.32

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.92 changed to 1.96
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $91.95changed to$93.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.88 changed to 1.92
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $92.28changed to$91.95

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $91.82changed to$92.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $91.59changed to$91.82

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $111.16changed to$91.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.57 changed to 1.86
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $111.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$97.64$26.16RVU26D
2026-07-01$97.64$26.16RVU26C
2026-04-01$97.64$26.16RVU26B
2026-01-01$97.64$26.16RVU26A
2025-10-01$96.84$29.88RVU25D
2025-07-01$96.84$29.88RVU25C
2025-04-01$96.84$29.88RVU25B
2025-01-01$96.84$29.88RVU25A
2024-10-01$100.66$30.42RVU24D
2024-07-01$100.66$30.42RVU24C
2024-04-01$100.66$30.42RVU24B
2024-03-09$100.66$30.42RVU24AR
2024-01-01$99.01$29.92RVU24A
2023-10-01$102.80$31.30RVU23D
2023-07-01$102.80$31.30RVU23C
2023-04-01$102.80$31.30RVU23B
2023-01-01$102.80$31.30RVU23A
2022-10-01$103.94$31.61RVU22D
2022-07-01$103.94$31.61RVU22C
2022-04-01$103.94$31.61RVU22B
2022-01-01$103.94$31.61RVU22A
2021-10-01$103.75$31.87RVU21D
2021-07-01$103.75$31.87RVU21C
2021-04-01$103.75$31.87RVU21B
2021-01-01$103.75$31.87RVU21A
2020-10-01$99.38$32.97RVU20D
2020-07-01$99.38$32.97RVU20C
2020-04-01$99.38$32.97RVU20B
2020-01-01$99.38$32.97RVU20A
2019-10-01$97.59$33.08RVU19D
2019-07-01$97.59$33.08RVU19C
2019-04-01$97.59$33.08RVU19B
2019-01-01$97.59$33.08RVU19A
2018-10-01$95.32$33.40RVU18D
2018-07-01$95.32$33.40RVU18C
2018-04-01$95.32$33.40RVU18B
2018-01-01$95.32$33.40RVU18AR1
2017-10-01$93.59$33.30RVU17D
2017-07-01$93.59$33.30RVU17C
2017-04-01$93.59$33.30RVU17B
2017-01-01$93.59$33.30RVU17A
2016-10-01$91.95$32.87RVU16D
2016-07-01$91.95$32.87RVU16C
2016-04-01$91.95$32.87RVU16B
2016-01-01$91.95$32.87RVU16A
2015-10-01$92.28$32.99RVU15D
2015-07-01$92.28$32.99RVU15C
2015-04-01$91.82$32.82RVU15B
2015-01-01$91.82$32.82RVU15A
2014-10-01$91.59$33.55RVU14D
2014-07-01$91.59$33.55RVU14C
2014-04-01$91.59$33.55RVU14B
2014-01-01$91.59$33.55RVU14A
2013-10-01$111.16$39.37RVU13D
2013-07-01$111.16$39.37RVU13C
2013-04-01$111.16$39.37RVU13B
2013-01-01$111.16$39.37RVU13AR

Price 92316 for an earlier date of service

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

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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