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See a sample rate comparisonCPT 92316 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.
C Lens Fitg Tech Aphakia Ou, Prescription Of Optical And Physical Characteristics Of Contact Lens With Medical Supervision Of Adaptation And Direction Of Fitting By Independent Technician 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 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | RT - Right side of body 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $97.87 national non-facility rate (2026) · View Medicare rates for 92316 |
| Medicaid Fee Schedule | $77.93 median of the 8 states in the free preview · View Medicaid rates for 92316 |
National average reimbursement for CPT 92316 by major payers:
$107.83
$110.08
$112.06
$61.99
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CPT 92316
5 of 25 sample ratesHigher to lower in this preview
John Millichap
Warren Clinic Inc
$243.05Published rateParag Merai
Advocate Health And Hospitals Corporation
$175.46Published rateJoseph Divincenzo
Loyola University Medical Center
$164.91Published rateMichael Naylor
The Board Of Trustees Of The University Of Illinois
$123.68Published rateBama Heart Doc, P.C., Alabama Heart And Vascular Medicine
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$34.20Published rate
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See a sample payer proposalCPT 92316 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92316 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 92316 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 |
|---|---|---|
| 92314-CPT | Low | Fitting Of Contact Lens, Prescription Of Optical And Physical Characteristics Of Contact Lens With Medical Supervision Of Adaptation And Direction Of Fitting By Independent Technician; Corneal Lens Both Eyes Except For Aphakia |
| 92315-CPT | Low | C Lens Fitg Tech Aphakia 1, Prescription Of Optical And Physical Characteristics Of Contact Lens With Medical Supervision Of Adaptation And Direction Of Fitting By Independent Technician Corneal Lens For Aphakia 1 Eye |
| 92316-CPT | Low | C Lens Fitg Tech Aphakia Ou, Prescription Of Optical And Physical Characteristics Of Contact Lens With Medical Supervision Of Adaptation And Direction Of Fitting By Independent Technician Corneal Lens For Aphakia Both Eyes |
| 92317-CPT | Low | C Lens Fitg Tech Corneosclrl, Prescription Of Optical And Physical Characteristics Of Contact Lens With Medical Supervision Of Adaptation And Direction Of Fitting By Independent Technician 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 92316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92316 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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