V2207 — Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens
HCPCS Level II V-code · short descriptor: “Lens sphcy bifocal 4.25-7d/.”
- 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.
V2207 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $69.95 to $94.02 depending on state and rural status.
Former-CBA payment limits: ceiling $93.27 · floor $69.95
| State | Non-rural | Rural |
|---|---|---|
| AK | $87.96 | — |
| AL | $76.56 | — |
| AR | $72.01 | — |
| AZ | $85.22 | — |
| CA | $85.22 | — |
| CO | $78.36 | — |
| CT | $76.33 | — |
| DC | $90.63 | — |
| DE | $90.63 | — |
| FL | $76.56 | — |
| GA | $76.56 | — |
| HI | $94.02 | — |
| IA | $69.95 | — |
| ID | $74.84 | — |
| IL | $74.72 | — |
| IN | $74.72 | — |
| KS | $69.95 | — |
| KY | $76.56 | — |
| LA | $72.01 | — |
| MA | $76.33 | — |
| MD | $90.63 | — |
| ME | $76.33 | — |
| MI | $74.72 | — |
| MN | $74.72 | — |
| MO | $69.95 | — |
| MS | $76.56 | — |
| MT | $78.36 | — |
| NC | $76.56 | — |
| ND | $78.36 | — |
| NE | $69.95 | — |
| NH | $76.33 | — |
| NJ | $87.88 | — |
| NM | $72.01 | — |
| NV | $85.22 | — |
| NY | $87.88 | — |
| OH | $74.72 | — |
| OK | $72.01 | — |
| OR | $74.84 | — |
| PA | $90.63 | — |
| PR | $72.09 | — |
| RI | $76.33 | — |
| SC | $76.56 | — |
| SD | $78.36 | — |
| TN | $76.56 | — |
| TX | $72.01 | — |
| UT | $78.36 | — |
| VA | $90.63 | — |
| VI | $87.88 | — |
| VT | $76.33 | — |
| WA | $74.84 | — |
| WI | $74.72 | — |
| WV | $90.63 | — |
| WY | $78.36 | — |
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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