V2103 — Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens
HCPCS Level II V-code · short descriptor: “Spherocylindr 4.00d/12-2.00d”
- Code system
- HCPCS Level II
- Family
- V — Vision & hearing services
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Prosthetics & orthotics
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
V2103 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $41.63 to $58.09 depending on state and rural status.
Former-CBA payment limits: ceiling $55.51 · floor $41.63
| State | Non-rural | Rural |
|---|---|---|
| AK | $46.64 | — |
| AL | $41.63 | — |
| AR | $44.55 | — |
| AZ | $45.79 | — |
| CA | $45.79 | — |
| CO | $51.53 | — |
| CT | $41.63 | — |
| DC | $55.51 | — |
| DE | $55.51 | — |
| FL | $41.63 | — |
| GA | $41.63 | — |
| HI | $49.91 | — |
| IA | $41.63 | — |
| ID | $52.08 | — |
| IL | $47.91 | — |
| IN | $47.91 | — |
| KS | $41.63 | — |
| KY | $41.63 | — |
| LA | $44.55 | — |
| MA | $41.63 | — |
| MD | $55.51 | — |
| ME | $41.63 | — |
| MI | $47.91 | — |
| MN | $47.91 | — |
| MO | $41.63 | — |
| MS | $41.63 | — |
| MT | $51.53 | — |
| NC | $41.63 | — |
| ND | $51.53 | — |
| NE | $41.63 | — |
| NH | $41.63 | — |
| NJ | $55.51 | — |
| NM | $44.55 | — |
| NV | $45.79 | — |
| NY | $55.51 | — |
| OH | $47.91 | — |
| OK | $44.55 | — |
| OR | $52.08 | — |
| PA | $55.51 | — |
| PR | $58.09 | — |
| RI | $41.63 | — |
| SC | $41.63 | — |
| SD | $51.53 | — |
| TN | $41.63 | — |
| TX | $44.55 | — |
| UT | $51.53 | — |
| VA | $55.51 | — |
| VI | $55.51 | — |
| VT | $41.63 | — |
| WA | $52.08 | — |
| WI | $47.91 | — |
| WV | $55.51 | — |
| WY | $51.53 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related V-codes
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