$34.41
Choose 92072 for an initial contact lens fitting to manage keratoconus. Choose 92071 when the lens is fitted to treat an ocular-surface condition.
On this page
CMS RVU26D · Effective 2026-10-01
92072 Contact lens fitting Medicare reimbursement rates in Ohio
An initial specialty contact lens fitting for keratoconus, reported when an eye-care clinician selects and evaluates a lens to manage corneal irregularity. Compare 92072 office and facility rates across CMS payment localities in Ohio.
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 92072 in Ohio?
Ohio 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
$115.39
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$75.44
1 of 1 localities have a supported rate.
Payment area: Ohio
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 92072: Initial keratoconus contact lens fitting
An initial specialty contact lens fitting for keratoconus, reported when an eye-care clinician selects and evaluates a lens to manage corneal irregularity.
Ophthalmologists and optometrists use this service to fit a contact lens for a patient with keratoconus, whose irregular corneal shape can limit vision with spectacles. The clinician evaluates lens position, movement, vision, and fit; rigid gas-permeable and scleral lenses are common options. The service may take place in an ophthalmology or optometry office where the clinician can assess the cornea and evaluate the lens on the eye.
Report 92072 for the initial fitting specifically for keratoconus, rather than a general contact lens fitting or a therapeutic lens fitting for an ocular-surface condition. Documentation should identify keratoconus and support the fitting work, including the lens fit and clinical assessment. CMS prices this code as bilateral, so modifier 50 does not increase payment. The CMS bilateral pricing applies whether the fitting involves one eye or both.
CMS billing rules for 92072
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU1.92 · 53%
- Practice expense (office) RVU1.67 · 46%
- Malpractice RVU0.01 · 0%
2K
Medicare services in 2024 · #2449 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.
92072 compared with similar codes
Office rates for Ohio, from the same CMS release.
92310
No office rateContact lens fitting ou
92310 describes a general contact lens fitting. 92072 is the keratoconus-specific code for the initial fitting.
$34.90
92025 reports computerized corneal topography, not the contact lens fitting itself. 92072 reports the initial fitting for keratoconus.
Compare 92072 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
Ohio →
Office / nonfacility
$115.39
Facility
$75.44
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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 92072 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
11,676
- Code
- 92072
- Physician work
- 1.92
- Practice expense
- 1.67
- Malpractice
- 0.01
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.92 | × 1.000 | 1.9200 |
| Practice expense | 1.67 | × 0.913 | 1.5247 |
| Malpractice | 0.01 | × 1.008 | 0.0101 |
| Total RVUs | 3.4548 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$115.39
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.92 | 1 |
| Practice expense | 1.67 | 0.913 |
| Malpractice | 0.01 | 1.008 |
(1.92 × 1 + 1.67 × 0.913 + 0.01 × 1.008) × $33.4009 = $115.39
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.92 | 1 |
| Practice expense | 0.36 | 0.913 |
| Malpractice | 0.01 | 1.008 |
(1.92 × 1 + 0.36 × 0.913 + 0.01 × 1.008) × $33.4009 = $75.44
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.
92072 billing questions
How is 92072 different from 92071?
92072 is for an initial contact lens fitting to manage keratoconus. 92071 is for fitting a contact lens to treat an ocular-surface condition.
Can 92072 be reported for one eye?
Yes. CMS prices 92072 as bilateral even when the fitting involves only one eye.
Should modifier 50 be appended?
Modifier 50 does not increase payment for 92072 because CMS already prices the code as bilateral.
Is corneal topography part of the fitting?
92072 represents the contact lens fitting, while 92025 represents computerized corneal topography. Report topography separately only when it is performed and documented as a distinct service.
What documentation supports 92072?
Document keratoconus as the reason for the fitting and describe the lens assessment, including fit and clinical evaluation.
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.
11,67392065,,Orthop traing pfrmd phys/qhp,A,,0.69,0.45,,0.12,,0.01,1.15,0.82,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,67492066,,Orthop traing supvj phys/qhp,A,,0.00,0.77,,0.77,NA,0.01,0.78,0.78,3,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
11,67592071,,Contact lens fitting for tx,A,,0.59,0.46,,0.17,,0.02,1.07,0.78,0,XXX,0.00,0.00,0.00,0,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,67692072,,Fitg c-lens keratoconus 1st,A,,1.92,1.67,,0.36,,0.01,3.60,2.29,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,67792081,,Limited visual field xm,A,,0.29,0.70,,0.70,NA,0.02,1.01,1.01,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,67892081,26,Limited visual field xm,A,,0.29,0.17,,0.17,,0.01,0.47,0.47,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,67992081,TC,Limited visual field xm,A,,0.00,0.53,,0.53,NA,0.01,0.54,0.54,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703