V2311 — Spherocylinder, trifocal, 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 sphc trifo 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.
V2311 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $109.08 to $152.73 depending on state and rural status.
Former-CBA payment limits: ceiling $145.44 · floor $109.08
| State | Non-rural | Rural |
|---|---|---|
| AK | $142.83 | — |
| AL | $133.12 | — |
| AR | $131.08 | — |
| AZ | $131.24 | — |
| CA | $131.24 | — |
| CO | $109.08 | — |
| CT | $137.56 | — |
| DC | $122.68 | — |
| DE | $122.68 | — |
| FL | $133.12 | — |
| GA | $133.12 | — |
| HI | $152.73 | — |
| IA | $109.08 | — |
| ID | $109.08 | — |
| IL | $128.65 | — |
| IN | $128.65 | — |
| KS | $109.08 | — |
| KY | $133.12 | — |
| LA | $131.08 | — |
| MA | $137.56 | — |
| MD | $122.68 | — |
| ME | $137.56 | — |
| MI | $128.65 | — |
| MN | $128.65 | — |
| MO | $109.08 | — |
| MS | $133.12 | — |
| MT | $109.08 | — |
| NC | $133.12 | — |
| ND | $109.08 | — |
| NE | $109.08 | — |
| NH | $137.56 | — |
| NJ | $109.49 | — |
| NM | $131.08 | — |
| NV | $131.24 | — |
| NY | $109.49 | — |
| OH | $128.65 | — |
| OK | $131.08 | — |
| OR | $109.08 | — |
| PA | $122.68 | — |
| PR | $118.08 | — |
| RI | $137.56 | — |
| SC | $133.12 | — |
| SD | $109.08 | — |
| TN | $133.12 | — |
| TX | $131.08 | — |
| UT | $109.08 | — |
| VA | $122.68 | — |
| VI | $109.49 | — |
| VT | $137.56 | — |
| WA | $109.08 | — |
| WI | $128.65 | — |
| WV | $122.68 | — |
| WY | $109.08 | — |
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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