$49.15–$55.73
Use 92326 when a lens is replaced. Use 92325 when an existing contact lens is modified instead.
On this page
CMS RVU26D · Effective 2026-10-01
92326 Lens replacement Medicare reimbursement rates in Massachusetts
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. Compare 92326 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 92326 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
$41.06–$46.56
2 of 2 localities have a supported rate.
Facility setting
No 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.
Contact lens services
About 92326: Replacement contact lens service
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.
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.
CMS billing rules for 92326
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU1.16 · 99%
- Malpractice RVU0.01 · 1%
1.3K
Medicare services in 2024 · #2766 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.
92326 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
Compare 92326 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
$46.56
Facility
Unavailable
Rest Of Massachusetts →
Office / nonfacility
$41.06
Facility
Unavailable
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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 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.
11,76092316,,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
11,76492340,,Fit spectacles monofocal,N,+,0.36,0.69,,0.08,,0.02,1.07,0.46,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,76592341,,Fit spectacles bifocal,N,+,0.46,0.73,,0.10,,0.03,1.22,0.59,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,76692342,,Fit spectacles multifocal,N,+,0.52,0.76,,0.11,,0.03,1.31,0.66,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00