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See a sample rate comparisonCPT 92326 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.
Replacement Of Contact Lens
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Ophthalmology Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $39.08 national non-facility rate (2026) · View Medicare rates for 92326 |
| Medicaid Fee Schedule | $33.365 median of the 8 states in the free preview · View Medicaid rates for 92326 |
National average reimbursement for CPT 92326 by major payers:
$55.99
$48.66
$44.66
$64.05
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CPT 92326
5 of 25 sample ratesHigher to lower in this preview
Mark Wainwright
Pediatric Faculty Foundation In
$87.87Published rateMark Alter
$73.76Published rateDavid Hsu
Bellin Memorial Hospital Inc
$67.11Published rateKelley Volpe
The Board Of Trustees Of The University Of Illinois
$48.06Published rateHugo Solari
Esperanza Health Centers
$38.06Published rate
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See a sample payer proposalCPT 92326 vs. Other Ophthalmology Services and Procedures Codes
The CPT 92326 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 92326 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 |
| 92326-CPT | Low | Replacement Of Contact Lens |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92326. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92326 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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