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CMS RVU26D · Effective 2026-10-01

92325 Lens modification Medicare reimbursement rates in Michigan

Report this service when an existing contact lens is physically altered, such as by polishing, rather than fitted or replaced. Compare 92325 office and facility rates across CMS payment localities in Michigan.

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 92325 in Michigan?

Michigan 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

$42.77–$45.37

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $2.60 per service.

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.

Find 92325 in your payment locality →

Optometry

About 92325: Contact lens modification

Report this service when an existing contact lens is physically altered, such as by polishing, rather than fitted or replaced.

This service covers a physical change to an existing contact lens, such as polishing or altering the lens. It is distinct from evaluating the patient for a new lens fit and from supplying a replacement lens. Ophthalmologists and optometrists may perform or supervise contact lens care in an office setting; trained staff may carry out the modification under the required physician supervision.

Report 92325 when the record identifies the lens modified, the change made, and the clinical reason for altering it. The documentation should distinguish the work from fitting a lens or replacing one. CMS classifies the service as incident-to, so it may be billed only when performed under physician supervision. The CMS relative-value data assign zero work RVUs, with practice-expense and malpractice RVUs; office and facility practice-expense values are the same.

CMS billing rules for 92325

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) RVU1.39 · 99%
  • Malpractice RVU0.01 · 1%

210

Medicare services in 2024 · #4281 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.

92325 compared with similar codes

Office rates for Michigan, from the same CMS release.

92326

Lens replacement

Existing contact lens

$35.75–$37.95

92325 covers physically altering an existing lens; 92326 covers replacing the lens.

92310

Contact lens fitting ou

No office rate

92310 describes contact lens fitting. Choose 92325 when the service is a physical alteration to an existing lens, not fitting.

92314

C-lens fitg tech ou

No office rate

92314 is a technician-performed contact lens fitting service for both eyes. 92325 describes physical alteration of a lens.

Compare 92325 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

Office and facility base rates · shared scale starting at $0

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92325 billing questions

When should 92325 be used instead of a contact lens fitting code?

Use 92325 for a physical alteration to an existing lens, such as polishing. A fitting code describes the fitting service, not the alteration itself.

How is 92325 different from 92326?

92325 represents altering an existing lens. 92326 represents replacing a contact lens; use the code that matches the service actually performed.

What documentation supports 92325?

Document which lens was modified, what physical change was made, and why the alteration was needed. The record should make clear that the service was not a fitting or replacement.

Can staff perform the modification and bill 92325?

CMS classifies 92325 as incident-to and permits billing only when the service is performed under physician supervision.

Can 92325 be reported with a contact lens fitting code?

A fitting and a distinct physical lens modification may be separate services when both are performed and documented. The record should identify each service rather than treating fitting work as a lens alteration.

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.

RVUs for 92325PPRRVU2026_Oct_nonQPP.csv, line 11,762 (RVU26D)