Billing code 92312: Contact lens fittingMedicare rate & RVUs in Washington
Reports contact lens fitting for aphakia in both eyes, including lens selection and clinical assessment of fit and adaptation.
Medicare pays $117.49–$131.52 for 92312 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 92312 covers
An ophthalmologist or optometrist uses this code when fitting contact lenses for a patient who is aphakic in both eyes, such as after removal of the crystalline lenses. The service involves assessing the eyes and visual needs, selecting lens characteristics, evaluating fit and vision, and supervising the patient’s adaptation. It is a clinical fitting service, not a report for the contact lenses themselves.
Report 92312 when the fitting addresses aphakia in both eyes; use the unilateral sibling when only one eye is fitted for aphakia. Documentation should identify the aphakia, both eyes, the fitting work performed, lens specifications selected, and the clinical assessment of fit or adaptation. CMS prices this code as bilateral, so report it once for both eyes; modifier 50 does not increase payment.
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.
Where 92312 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $117.49 | $49.96 |
| Seattle (King Cnty) | $131.52 | $52.84 |
How the 92312 rate is calculated
Each of 92312’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 92312
RVUs × geographic indexes × conversion factor
Work1.23
1.23 RVUs× 1.000 GPCI
Practice expense2.15
2.15 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
3.3900
Conversion factor
$33.4009
Medicare rate
$113.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92312
The CMS indicators that decide how 92312 is paid alongside other services.
CMS payment indicators · 92312
Contact lens fitting
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
92312 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 92311Contact lens fitting
- 92311 is for aphakia fitting in one eye; 92312 is for both eyes and is already priced bilaterally.
- 92310Contact lens fitting ou
- 92310 is the general bilateral contact lens fitting code. Choose 92312 when the fitting is for aphakia in both eyes.
- 92316Contact lens fitting
- 92316 is the technician fitting counterpart for bilateral aphakia. Choose 92312 for the physician or other qualified eye-care professional fitting service.
- 92313Contact lens fitting
- 92313 identifies fitting for a corneoscleral lens. 92312 is selected for bilateral aphakia fitting when that distinct lens type is not the basis for the code.
92312 billing questions
Should 92312 be reported once or once for each eye?
Report 92312 once for a bilateral aphakia fitting. CMS prices the code as bilateral, and modifier 50 does not increase payment.
When is 92311 a better choice?
Use 92311 when the aphakia contact lens fitting is for one eye. 92312 describes the fitting for both eyes.
How does 92312 differ from 92310?
92312 is for fitting contact lenses for aphakia in both eyes. 92310 is the general bilateral fitting code for situations other than aphakia.
How does the technician fitting code differ?
92316 describes a technician-performed bilateral aphakia fitting. 92312 is the corresponding fitting service performed by a physician or other qualified eye-care professional.
What should the record show?
Document aphakia in both eyes, the fitting and lens-selection work, and the assessment of lens fit, vision, or adaptation. The record should make clear that the fitting addressed both eyes.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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