$38.53
92325 covers physically altering an existing lens; 92326 covers replacing the lens.
On this page
CMS RVU26D · Effective 2026-10-01
92325 Lens modification Medicare reimbursement rates in Vermont
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 Vermont.
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 Vermont?
Vermont 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
$46.13
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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.
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 Vermont, from the same CMS release.
92310
No office rateContact lens fitting ou
92310 describes contact lens fitting. Choose 92325 when the service is a physical alteration to an existing lens, not fitting.
92314
No office rateC-lens fitg tech ou
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.
1 of 1 payment localities
Vermont →
Office / nonfacility
$46.13
Facility
Unavailable
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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 92325 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
11,762
- Code
- 92325
- Physician work
- 0.00
- Practice expense
- 1.39
- Malpractice
- 0.01
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 1.39 | × 0.990 | 1.3761 |
| Malpractice | 0.01 | × 0.506 | 0.0051 |
| Total RVUs | 1.3812 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$46.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 1.39 | 0.99 |
| Malpractice | 0.01 | 0.506 |
(0 × 1 + 1.39 × 0.99 + 0.01 × 0.506) × $33.4009 = $46.13
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.
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.
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
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817