V2500 — Contact lens, pmma, spherical, per lens
HCPCS Level II V-code · short descriptor: “Contact lens pmma spherical”
- 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.
V2500 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $99.50 to $387.16 depending on state and rural status.
Former-CBA payment limits: ceiling $132.67 · floor $99.50
| State | Non-rural | Rural |
|---|---|---|
| AK | $108.85 | — |
| AL | $99.50 | — |
| AR | $124.39 | — |
| AZ | $107.64 | — |
| CA | $107.64 | — |
| CO | $105.25 | — |
| CT | $104.36 | — |
| DC | $132.67 | — |
| DE | $132.67 | — |
| FL | $99.50 | — |
| GA | $99.50 | — |
| HI | $116.35 | — |
| IA | $103.08 | — |
| ID | $132.67 | — |
| IL | $112.64 | — |
| IN | $112.64 | — |
| KS | $103.08 | — |
| KY | $99.50 | — |
| LA | $124.39 | — |
| MA | $104.36 | — |
| MD | $132.67 | — |
| ME | $104.36 | — |
| MI | $112.64 | — |
| MN | $112.64 | — |
| MO | $103.08 | — |
| MS | $99.50 | — |
| MT | $105.25 | — |
| NC | $99.50 | — |
| ND | $105.25 | — |
| NE | $103.08 | — |
| NH | $104.36 | — |
| NJ | $132.67 | — |
| NM | $124.39 | — |
| NV | $107.64 | — |
| NY | $132.67 | — |
| OH | $112.64 | — |
| OK | $124.39 | — |
| OR | $132.67 | — |
| PA | $132.67 | — |
| PR | $387.16 | — |
| RI | $104.36 | — |
| SC | $99.50 | — |
| SD | $105.25 | — |
| TN | $99.50 | — |
| TX | $124.39 | — |
| UT | $105.25 | — |
| VA | $132.67 | — |
| VI | $132.67 | — |
| VT | $104.36 | — |
| WA | $132.67 | — |
| WI | $112.64 | — |
| WV | $132.67 | — |
| WY | $105.25 | — |
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
Bill V2500 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →