$117.62–$128.81
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.
On this page
CMS RVU26D · Effective 2026-10-01
92316 Contact lens fitting Medicare reimbursement rates in Massachusetts
Reports technician-performed contact lens fitting for aphakia in both eyes, including assessment and selection of lenses to address the absence of natural lenses. Compare 92316 office and facility rates across CMS payment localities in Massachusetts.
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 92316 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$102.15–$113.38
2 of 2 localities have a supported rate.
Facility setting
$26.88–$28.03
2 of 2 localities have a supported rate.
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.
Vision services
About 92316: Technician aphakia contact lens fitting, both eyes
Reports technician-performed contact lens fitting for aphakia in both eyes, including assessment and selection of lenses to address the absence of natural lenses.
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.
CMS billing rules for 92316
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.66 · 23%
- Practice expense (office) RVU2.26 · 77%
- Malpractice RVU0.01 · 0%
30
Medicare services in 2024 · #5680 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.
92316 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$82.73–$92.17
Both identify technician-performed contact lens fitting for aphakia. Code 92315 is for one eye; 92316 is for both eyes.
92314
No office rateC-lens fitg tech ou
Both describe technician-performed fitting for both eyes, but 92316 is for aphakia and 92314 is for fitting without aphakia.
Compare 92316 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$113.38
Facility
$28.03
Rest Of Massachusetts →
Office / nonfacility
$102.15
Facility
$26.88
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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 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.
11,75792313,,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
11,75992315,,C-lens fitg tech aphakia 1,A,,0.44,1.92,,0.08,,0.01,2.37,0.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,76092316,,C-lens fitg tech aphakia ou,A,,0.66,2.26,,0.12,,0.01,2.93,0.79,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,76192317,,C-lens fitg tech corneosclrl,A,,0.44,2.05,,0.08,,0.01,2.50,0.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,76292325,,Modification of contact lens,A,,0.00,1.39,,1.39,NA,0.01,1.40,1.40,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,76392326,,Replacement of contact lens,A,,0.00,1.16,,1.16,NA,0.01,1.17,1.17,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00