V2211 — Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens
HCPCS Level II V-code · short descriptor: “Lens sphcy bifo 7.25-12/.25-”
- 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.
V2211 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $90.41 to $131.58 depending on state and rural status.
Former-CBA payment limits: ceiling $120.55 · floor $90.41
| State | Non-rural | Rural |
|---|---|---|
| AK | $123.12 | — |
| AL | $93.51 | — |
| AR | $90.41 | — |
| AZ | $114.10 | — |
| CA | $114.10 | — |
| CO | $120.55 | — |
| CT | $98.90 | — |
| DC | $107.54 | — |
| DE | $107.54 | — |
| FL | $93.51 | — |
| GA | $93.51 | — |
| HI | $131.58 | — |
| IA | $90.41 | — |
| ID | $104.94 | — |
| IL | $90.41 | — |
| IN | $90.41 | — |
| KS | $90.41 | — |
| KY | $93.51 | — |
| LA | $90.41 | — |
| MA | $98.90 | — |
| MD | $107.54 | — |
| ME | $98.90 | — |
| MI | $90.41 | — |
| MN | $90.41 | — |
| MO | $90.41 | — |
| MS | $93.51 | — |
| MT | $120.55 | — |
| NC | $93.51 | — |
| ND | $120.55 | — |
| NE | $90.41 | — |
| NH | $98.90 | — |
| NJ | $102.35 | — |
| NM | $90.41 | — |
| NV | $114.10 | — |
| NY | $102.35 | — |
| OH | $90.41 | — |
| OK | $90.41 | — |
| OR | $104.94 | — |
| PA | $107.54 | — |
| PR | $91.49 | — |
| RI | $98.90 | — |
| SC | $93.51 | — |
| SD | $120.55 | — |
| TN | $93.51 | — |
| TX | $90.41 | — |
| UT | $120.55 | — |
| VA | $107.54 | — |
| VI | $102.37 | — |
| VT | $98.90 | — |
| WA | $104.94 | — |
| WI | $90.41 | — |
| WV | $107.54 | — |
| WY | $120.55 | — |
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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