$112.54
Choose 92312 when both aphakic eyes are fitted. 92311 describes fitting one aphakic eye.
On this page
CMS RVU26D · Effective 2026-10-01
92311 Contact lens fitting Medicare reimbursement rates in Delaware
Reports the clinical fitting of a contact lens for one aphakic eye, including lens selection, fit assessment, and medical oversight during adaptation. Compare 92311 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92311 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$98.25
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$42.15
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Contact lens services
About 92311: Aphakic contact lens fitting, one eye
Reports the clinical fitting of a contact lens for one aphakic eye, including lens selection, fit assessment, and medical oversight during adaptation.
92311 covers contact lens fitting for one aphakic eye, meaning the eye lacks its natural crystalline lens. A typical situation is aphakia after cataract removal when no intraocular lens was placed; congenital aphakia is another possible cause. An ophthalmologist or optometrist selects the lens characteristics, evaluates fit and visual effect, and oversees the patient’s adaptation. The service may include trial-lens assessment and instruction in lens handling, usually in an eye-care office.
Report 92311 for fitting one eye. When both aphakic eyes are fitted, 92312 is the bilateral sibling rather than two units of 92311. Documentation should identify the eye and support the aphakic diagnosis, fitting performed, and lens characteristics selected. Distinguish a fitting from a routine fitting for an eye without aphakia, a technician-performed fitting, or a later lens adjustment or replacement. CMS values the service using physician work, practice expense, and malpractice inputs; the practice-expense inputs differ between office and facility settings.
Where the value comes from
- Work RVU1.05 · 35%
- Practice expense (office) RVU1.90 · 64%
- Malpractice RVU0.01 · 0%
251
Medicare services in 2024 · #4139 by national volume
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.
92311 compared with similar codes
Office rates for Delaware, from the same CMS release.
92310
No office rateContact lens fitting ou
92310 is for contact lens fitting in eyes without aphakia; 92311 is for one aphakic eye.
$78.43
92315 is the technician-performed fitting for one aphakic eye. 92311 describes the fitting service with medical oversight of adaptation.
$46.17
92325 describes modification of an existing contact lens. 92311 is for fitting a lens for one aphakic eye.
Compare 92311 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
$98.25
Facility
$42.15
Need rates for a whole code list?
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92311 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
11,755
- Code
- 92311
- Physician work
- 1.05
- Practice expense
- 1.90
- Malpractice
- 0.01
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.05 | × 1.005 | 1.0553 |
| Practice expense | 1.90 | × 0.988 | 1.8772 |
| Malpractice | 0.01 | × 0.899 | 0.0090 |
| Total RVUs | 2.9414 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$98.25
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.05 | 1.005 |
| Practice expense | 1.9 | 0.988 |
| Malpractice | 0.01 | 0.899 |
(1.05 × 1.005 + 1.9 × 0.988 + 0.01 × 0.899) × $33.4009 = $98.25
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.05 | 1.005 |
| Practice expense | 0.2 | 0.988 |
| Malpractice | 0.01 | 0.899 |
(1.05 × 1.005 + 0.2 × 0.988 + 0.01 × 0.899) × $33.4009 = $42.15
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
92311 billing questions
When should 92311 be used instead of 92312?
Use 92311 when the fitting is for one aphakic eye. Use 92312 when both aphakic eyes are fitted; do not report two units of 92311 for that bilateral fitting.
How should the record identify the eye?
Document which eye is aphakic and being fitted, along with the fitting work and selected lens characteristics. The code represents one eye.
Is this the code for fitting a contact lens in a nonaphakic eye?
No. For a standard corneal contact lens fitting in an eye without aphakia, consider 92310; 92311 is specific to aphakia in one eye.
Does 92311 describe lens modification or replacement?
No. Code 92325 describes modification of an existing contact lens, while 92326 describes replacement; 92311 is for the aphakic fitting service.
How does 92311 differ from 92315?
Both concern fitting for aphakia in one eye. 92315 is the technician-performed fitting code; 92311 describes the fitting service with medical oversight of adaptation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,75292287,TC,Ant sgm img ir flrscn angrph,A,,0.00,3.37,,3.37,NA,0.01,3.38,3.38,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,4.06,4.06,0.01
11,75392288,,Scr dark adaptation meas i&r,N,+,0.17,0.53,,0.53,NA,0.01,0.71,0.71,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,75492310,,Contact lens fitting ou,N,+,1.14,1.81,,0.25,,0.07,3.02,1.46,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,75592311,,Contact lens fitg aphakia 1,A,,1.05,1.90,,0.20,,0.01,2.96,1.26,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,75692312,,Contact lens fitg aphakia ou,A,,1.23,2.15,,0.23,,0.01,3.39,1.47,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,75792313,,C-lens fitg corneosclrl lens,A,,0.90,1.95,,0.16,,0.01,2.86,1.07,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,75892314,,C-lens fitg tech ou,N,+,0.67,1.93,,0.15,,0.04,2.64,0.86,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503