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CPT code 92326: Lens replacement, existing contact lens2026 Medicare rate & RVUs in Connecticut

Report this service when a replacement contact lens is provided for an existing wearer, rather than when a new lens fitting or lens modification is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3K Medicare services in 2024

In Connecticut, Medicare pays $42.13 for 92326 in the office.

$42.13Office (non-facility)
Not available in this settingHospital or facility
+7.8%vs the national office rate ($39.08)

Check a contract rate as a % of Medicare · 92326 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 92326 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 92326 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 92326 covers

This service covers replacing a contact lens for someone who already wears contact lenses. An ophthalmologist or optometrist may provide or oversee the service in an eye-care office; a replacement may be needed when a lens is lost, damaged, or no longer usable. The replacement itself is distinct from evaluating and fitting a new lens or altering an existing lens.

Report one unit for each lens replaced, and document the eye, the replacement provided, and why it was needed. Do not treat dispensing a replacement as proof that a separate fitting or modification was performed. Under the CMS incident-to rule, office staff may perform the service for billing only when it is performed under physician supervision.

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 Connecticut compares for 92326

Across 109 of 109 payment localities, the office rate for 92326 runs from $33.45 in Arkansas to $56.05 in San Benito County, CA. Connecticut pays $42.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

92326 in Connecticut vs other payment areas
  1. Connecticut · this page$42.13
  2. Los Angeles, CA · California$46.06+$3.93
  3. Washington, DC area · District of Columbia$46.01+$3.88
  4. Miami, FL · Florida$41.18−$0.95
  5. Chicago, IL · Illinois$39.71−$2.42
  6. Manhattan, NY · New York$45.55+$3.42
  7. Alaska · Alaska$41.45−$0.68

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

Every other payment area

92326 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$34.09—
ArkansasArkansas$33.45—
ArizonaArizona$37.83—
Bakersfield, CACalifornia$42.67—
Chico, CACalifornia$42.64—
El Centro, CACalifornia$42.65—
Fresno, CACalifornia$42.64—
Hanford, CACalifornia$42.64—

92326 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.

$33.45

$49.35

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

View every state and territory as a table
92326 office rate range by state
State / territoryOffice rate rangeLocalities
AK$41.451
AL$34.091
AR$33.451
AZ$37.831
CA$42.64–$56.0529
CO$41.491
CT$42.131
DC$46.011
DE$38.581
FL$37.54–$41.183
GA$34.96–$39.772
GU$44.251
HI$44.251
IA$35.581
ID$35.801
IL$35.90–$40.384
IN$36.081
KS$35.191
KY$34.751
LA$34.61–$36.842
MA$41.06–$46.562
MD$39.52–$46.013
ME$35.85–$38.612
MI$35.75–$37.952
MN$39.971
MO$33.72–$37.223
MS$33.611
MT$39.081
NC$36.361
ND$38.881
NE$35.891
NH$40.631
NJ$42.68–$45.302
NM$35.931
NV$39.061
NY$37.04–$46.695
OH$35.711
OK$34.861
OR$38.82–$43.292
PA$35.88–$40.732
PR$39.501
RI$40.321
SC$36.081
SD$38.861
TN$35.401
TX$35.57–$41.298
UT$36.721
VA$38.32–$46.012
VI$39.501
VT$38.531
WA$41.05–$47.812
WI$37.221
WV$34.151
WY$38.991

See 92326 in every payment locality

How the 92326 rate is calculated

Each of 92326’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 · 92326

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense1.16

1.16 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

1.1700

Conversion factor

$33.4009

Medicare rate

$39.08

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,763

Code
92326
Physician work
0.00
Practice expense
1.16
Malpractice
0.01

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 92326 in Connecticut
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0200.0000
Practice expense1.16× 1.0771.2493
Malpractice0.01× 1.2100.0121
Total RVUs1.2614
Conversion factor× 33.4009

Office rate, Connecticut$42.13

Office: (0 × 1.02 + 1.16 × 1.077 + 0.01 × 1.21) × $33.4009 = $42.13

Open 92326 in the RVU calculator

Payment rules and modifiers for 92326

The CMS indicators that decide how 92326 is paid alongside other services.

CMS payment indicators · 92326

Lens replacement, existing contact lens

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical5Incident-to service.

Codes related to 92326

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

Codes related to 92326
CodeHow it relatesOffice range, Connecticut
Used instead
92310Contact lens fitting, both eyes; non-aphakicDescribes a contact lens fitting when fitting, rather than replacement alone, is performed.No office rate
92314Contact lens fitting, technician, both eyesDescribes a technician-performed contact lens fitting, not replacement of an existing lens.No office rate
92325Lens modification, physical lens alterationDescribes modification of a contact lens rather than replacing it.$50.41

How 92326 has changed in Connecticut

92326 · Office / nonfacility

$42.13

Effective 2026-10-01

The base rate is $1.51 higher than on 2025-10-01, moving from $40.62 to $42.13 (3.7%).

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

    $40.62changed to$42.13

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.14 changed to 1.16
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $42.89changed to$40.62

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.17 changed to 1.14

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $42.19changed to$42.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $43.31changed to$42.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.15 changed to 1.17
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $44.66changed to$43.31

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $44.64changed to$44.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.14 changed to 1.15

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $42.57changed to$44.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.05 changed to 1.14
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $42.13changed to$42.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.04 changed to 1.05
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $41.68changed to$42.13

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.03 changed to 1.04

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $39.73changed to$41.68

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.98 changed to 1.03
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $39.77changed to$39.73

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $39.92changed to$39.77

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $39.72changed to$39.92

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $40.02changed to$39.72

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.99 changed to 0.98
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $40.83changed to$40.02

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.07 changed to 0.99
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $40.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$42.13Not available in this settingRVU26D
2026-07-01$42.13Not available in this settingRVU26C
2026-04-01$42.13Not available in this settingRVU26B
2026-01-01$42.13Not available in this settingRVU26A
2025-10-01$40.62Not available in this settingRVU25D
2025-07-01$40.62Not available in this settingRVU25C
2025-04-01$40.62Not available in this settingRVU25B
2025-01-01$40.62Not available in this settingRVU25A
2024-10-01$42.89Not available in this settingRVU24D
2024-07-01$42.89Not available in this settingRVU24C
2024-04-01$42.89Not available in this settingRVU24B
2024-03-09$42.89Not available in this settingRVU24AR
2024-01-01$42.19Not available in this settingRVU24A
2023-10-01$43.31Not available in this settingRVU23D
2023-07-01$43.31Not available in this settingRVU23C
2023-04-01$43.31Not available in this settingRVU23B
2023-01-01$43.31Not available in this settingRVU23A
2022-10-01$44.66Not available in this settingRVU22D
2022-07-01$44.66Not available in this settingRVU22C
2022-04-01$44.66Not available in this settingRVU22B
2022-01-01$44.66Not available in this settingRVU22A
2021-10-01$44.64Not available in this settingRVU21D
2021-07-01$44.64Not available in this settingRVU21C
2021-04-01$44.64Not available in this settingRVU21B
2021-01-01$44.64Not available in this settingRVU21A
2020-10-01$42.57Not available in this settingRVU20D
2020-07-01$42.57Not available in this settingRVU20C
2020-04-01$42.57Not available in this settingRVU20B
2020-01-01$42.57Not available in this settingRVU20A
2019-10-01$42.13Not available in this settingRVU19D
2019-07-01$42.13Not available in this settingRVU19C
2019-04-01$42.13Not available in this settingRVU19B
2019-01-01$42.13Not available in this settingRVU19A
2018-10-01$41.68Not available in this settingRVU18D
2018-07-01$41.68Not available in this settingRVU18C
2018-04-01$41.68Not available in this settingRVU18B
2018-01-01$41.68Not available in this settingRVU18AR1
2017-10-01$39.73Not available in this settingRVU17D
2017-07-01$39.73Not available in this settingRVU17C
2017-04-01$39.73Not available in this settingRVU17B
2017-01-01$39.73Not available in this settingRVU17A
2016-10-01$39.77Not available in this settingRVU16D
2016-07-01$39.77Not available in this settingRVU16C
2016-04-01$39.77Not available in this settingRVU16B
2016-01-01$39.77Not available in this settingRVU16A
2015-10-01$39.92Not available in this settingRVU15D
2015-07-01$39.92Not available in this settingRVU15C
2015-04-01$39.72Not available in this settingRVU15B
2015-01-01$39.72Not available in this settingRVU15A
2014-10-01$40.02Not available in this settingRVU14D
2014-07-01$40.02Not available in this settingRVU14C
2014-04-01$40.02Not available in this settingRVU14B
2014-01-01$40.02Not available in this settingRVU14A
2013-10-01$40.83Not available in this settingRVU13D
2013-07-01$40.83Not available in this settingRVU13C
2013-04-01$40.83Not available in this settingRVU13B
2013-01-01$40.83Not available in this settingRVU13AR

Price 92326 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

92326 billing questions

When should I use 92326 instead of a contact lens fitting code?

Use 92326 for replacing a lens for an existing wearer. A fitting code describes a fitting service, not simply the provision of a replacement lens.

How many units should I report?

Report one unit for each lens replaced. Document which eye received the replacement.

Can office staff perform this service?

Yes, but CMS permits billing as an incident-to service only when it is performed under physician supervision.

Does a replacement include a fitting or lens modification?

The replacement service does not by itself establish that a fitting or modification occurred. Report those services only when they were separately performed and documented.

What documentation supports 92326?

Record the existing contact lens use, the eye and lens replaced, and the reason a replacement was needed.

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 92326PPRRVU2026_Oct_nonQPP.csv, line 11,763 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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