CPT 92310
Global XXXContact lens fitting ou
CPT 92310 Billing & Documentation Guide
CPT code 92310 (Contact lens fitting ou) is classified under Ophthalmology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.14, a non-facility practice expense RVU of 1.81, and a malpractice RVU of 0.07, a total non-facility RVU of 3.02 and facility RVU of 1.46. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $103.95, though rates vary from $91.21 to $130.7 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92310, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92310 with related codes; this code has 3 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Non-covered service
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 0 units of 92310 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92310
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.14 | 1.14 |
| Practice Expense RVU | 1.81 | 0.25 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 3.02 | 1.46 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92310
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $112.25 | $50.59 | $106.24 - $130.7 | 29 |
| Florida | $103.29 | $51 | $99.39 - $106.92 | 3 |
| Georgia | $98.61 | $48.89 | $94.79 - $102.42 | 2 |
| Illinois | $101.1 | $50.75 | $96.93 - $104.57 | 4 |
| Michigan | $98.13 | $49.21 | $95.91 - $100.36 | 2 |
| North Carolina | $95.98 | $47.36 | $95.98 - $95.98 | 1 |
| New York | $110.5 | $52.38 | $97.15 - $116.74 | 5 |
| Ohio | $95.63 | $48.06 | $95.63 - $95.63 | 1 |
| Pennsylvania | $100.13 | $49.1 | $95.78 - $104.49 | 2 |
| Texas | $99.98 | $48.68 | $95.26 - $104.19 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92310
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92310 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92310
What does CPT code 92310 mean? +
CPT code 92310 represents: Contact lens fitting ou. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92310? +
The 2026 Medicare national average non-facility payment for CPT 92310 is $103.95. Rates range from $91.21 to $130.7 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92310? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92310? +
This code has 3 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team