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V2212 — Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens

HCPCS Level II V-code · short descriptor: “Lens sphcyl bifo 7.25-12/2.2”

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
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.

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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

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

V2212 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $91.49 to $124.48 depending on state and rural status.

Former-CBA payment limits: ceiling $124.48 · floor $93.36

StateNon-ruralRural
AK$114.43
AL$101.77
AR$93.36
AZ$107.11
CA$107.11
CO$124.48
CT$107.56
DC$112.06
DE$112.06
FL$101.77
GA$101.77
HI$122.34
IA$93.36
ID$105.73
IL$94.64
IN$94.64
KS$93.36
KY$101.77
LA$93.36
MA$107.56
MD$112.06
ME$107.56
MI$94.64
MN$94.64
MO$93.36
MS$101.77
MT$124.48
NC$101.77
ND$124.48
NE$93.36
NH$107.56
NJ$103.99
NM$93.36
NV$107.11
NY$103.99
OH$94.64
OK$93.36
OR$105.73
PA$112.06
PR$91.49
RI$107.56
SC$101.77
SD$124.48
TN$101.77
TX$93.36
UT$124.48
VA$112.06
VI$103.99
VT$107.56
WA$105.73
WI$94.64
WV$112.06
WY$124.48
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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