CPT 92371
Global XXXRpr&refit spct prsth aphakia
CMS assigns this code a status indicator of "B", meaning it is not separately payable under the Physician Fee Schedule. Payment is bundled into another procedure.
CPT 92371 Billing & Documentation Guide
CPT code 92371 (Rpr&refit spct prsth aphakia) is classified under Ophthalmology with a global period indicator of XXX. This code uses the Always bundled payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.
When billing 92371, 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 92371 with related codes; this code has 5 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Bundled code (no separate payment, included in another service)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 0 units of 92371 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
2026 Medicare Reimbursement by State, CPT 92371
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 | $14.8 | $14.8 | $13.72 - $18 | 29 |
| Florida | $13.05 | $13.05 | $12.32 - $13.71 | 3 |
| Georgia | $12.19 | $12.19 | $11.42 - $12.96 | 2 |
| Illinois | $12.58 | $12.58 | $11.81 - $13.28 | 4 |
| Michigan | $12.08 | $12.08 | $11.66 - $12.49 | 2 |
| North Carolina | $11.74 | $11.74 | $11.74 - $11.74 | 1 |
| New York | $14.24 | $14.24 | $11.98 - $15.31 | 5 |
| Ohio | $11.62 | $11.62 | $11.62 - $11.62 | 1 |
| Pennsylvania | $12.46 | $12.46 | $11.66 - $13.26 | 2 |
| Texas | $12.48 | $12.48 | $11.56 - $13.37 | 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 92371
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92371 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 |
| 92352 | Column 1 (primary), can be billed with modifier | 9 | Mutually exclusive procedures |
| 92353 | Column 1 (primary), can be billed with modifier | 9 | Mutually exclusive procedures |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92371
What does CPT code 92371 mean? +
CPT code 92371 represents: Rpr&refit spct prsth aphakia. It's in the Ophthalmology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92371? +
The 2026 Medicare national average non-facility payment for CPT 92371 is $13.18. Rates range from $10.79 to $18 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92371? +
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 92371? +
This code has 5 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 April 17, 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