92071 Contact lens fitting for tx
What 92071 is
CMS fee schedule short descriptor: Contact lens fitting for tx.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 92071 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.59 | 0.46 | 0.02 | 1.07 | $35.74 |
| Facility (hospital, ASC) | 0.59 | 0.17 | 0.02 | 0.78 | $26.05 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 92071 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 92071? These codes are bundled into it
92071 is a Column 1 code in 4 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 1 - modifier may bypass | Check pair |
92071 is bundled into these codes
92071 appears as a Column 2 code in 36 active edits. Reported with one of these Column 1 codes on the same date of service, 92071 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0402T | Colgn crs-link crn&pachymtry | 1 | Check pair |
65220 | Remove foreign body from eye | 1 | Check pair |
65222 | Remove foreign body from eye | 1 | Check pair |
65275 | Repair of eye wound | 1 | Check pair |
65280 | Repair of eye wound | 1 | Check pair |
65286 | Repair of eye wound | 1 | Check pair |
65400 | Removal of eye lesion | 1 | Check pair |
65410 | Biopsy of cornea | 1 | Check pair |
65420 | Removal of eye lesion | 1 | Check pair |
65426 | Removal of eye lesion | 1 | Check pair |
65430 | Corneal smear | 1 | Check pair |
65435 | Curette/treat cornea | 1 | Check pair |
65436 | Curette/treat cornea | 1 | Check pair |
65450 | Treatment of corneal lesion | 1 | Check pair |
65600 | Revision of cornea | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.