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See a sample rate comparisonCPT 92312 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Contact Lens Fitg Aphakia Ou, Prescription Of Optical And Physical Characteristics Of And Fitting Of Contact Lens With Medical Supervision Of Adaptation Corneal Lens For Aphakia Both Eyes
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | KX - Requirements specified in the medical policy have been met SC - Medically necessary service or supply |
| Complexity Level | Low |
| Medicare Fee Schedule | $113.23 national non-facility rate (2026) · View Medicare rates for 92312 |
| Medicaid Fee Schedule | $90.225 median of the 8 states in the free preview · View Medicaid rates for 92312 |
National average reimbursement for CPT 92312 by major payers:
$136.28
$137.47
$136.61
$106.37
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CPT 92312
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$832.63Published rateAftab Poshni
Horizons Behavioral Health LLC
$255.33Published rateKavita Thakkar
Northwestern Memorial Healthcare
$210.77Published rateJamie Evans
Loyola University Medical Center
$204.00Published rateMajed Dalloul
Saint Anthony Health Affiliates
$59.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92312 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92312 code is part of the Medicine Services and Procedures services used for Ophthalmology Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 92312 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 92310-CPT | Low | Prescription Of Optical And Ph, Prescription Of Optical And Physical Characteristics Of And Fitting Of Contact Lens With Medical Supervision Of Adaptation Corneal Lens Both Eyesexcept For Aphakia |
| 92311-CPT | Low | Prescription Of Optical And Ph, Prescription Of Optical And Physical Characteristics Of And Fitting Of Contact Lens With Medical Supervision Of Adaptation Corneal Lens For Aphakia One Eye |
| 92312-CPT | Low | Contact Lens Fitg Aphakia Ou, Prescription Of Optical And Physical Characteristics Of And Fitting Of Contact Lens With Medical Supervision Of Adaptation Corneal Lens For Aphakia Both Eyes |
| 92313-CPT | Low | Prescription Of Optical And Ph, Prescription Of Optical And Physical Characteristics Of And Fitting Of Contact Lens With Medical Supervision Of Adaptation Corneoscleral Lens |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92312 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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