MyMedi-AI

V2108 — Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens

HCPCS Level II V-code · short descriptor: “Spherocylinder 4.25d/2.12-4d”

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
Face-to-face & WOPD
Not on the required list
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

V2108 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $54.87 to $73.24 depending on state and rural status.

Former-CBA payment limits: ceiling $73.15 · floor $54.87

StateNon-ruralRural
AK$68.49—
AL$58.41—
AR$65.19—
AZ$65.04—
CA$65.04—
CO$69.54—
CT$54.87—
DC$73.15—
DE$73.15—
FL$58.41—
GA$58.41—
HI$73.24—
IA$54.87—
ID$54.87—
IL$58.11—
IN$58.11—
KS$54.87—
KY$58.41—
LA$65.19—
MA$54.87—
MD$73.15—
ME$54.87—
MI$58.11—
MN$58.11—
MO$54.87—
MS$58.41—
MT$69.54—
NC$58.41—
ND$69.54—
NE$54.87—
NH$54.87—
NJ$70.32—
NM$65.19—
NV$65.04—
NY$70.32—
OH$58.11—
OK$65.19—
OR$54.87—
PA$73.15—
PR$58.09—
RI$54.87—
SC$58.41—
SD$69.54—
TN$58.41—
TX$65.19—
UT$69.54—
VA$73.15—
VI$70.32—
VT$54.87—
WA$54.87—
WI$58.11—
WV$73.15—
WY$69.54—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps V2108 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related V-codes

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