V2513 — Contact lens, gas permeable, extended wear, per lens
HCPCS Level II V-code · short descriptor: “Contact lens extended wear”
- 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.
V2513 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $193.62 to $387.16 depending on state and rural status.
Former-CBA payment limits: ceiling $258.16 · floor $193.62
| State | Non-rural | Rural |
|---|---|---|
| AK | $261.74 | — |
| AL | $193.62 | — |
| AR | $258.16 | — |
| AZ | $249.14 | — |
| CA | $249.14 | — |
| CO | $193.62 | — |
| CT | $220.94 | — |
| DC | $233.21 | — |
| DE | $233.21 | — |
| FL | $193.62 | — |
| GA | $193.62 | — |
| HI | $279.94 | — |
| IA | $193.62 | — |
| ID | $211.42 | — |
| IL | $258.16 | — |
| IN | $258.16 | — |
| KS | $193.62 | — |
| KY | $193.62 | — |
| LA | $258.16 | — |
| MA | $220.94 | — |
| MD | $233.21 | — |
| ME | $220.94 | — |
| MI | $258.16 | — |
| MN | $258.16 | — |
| MO | $193.62 | — |
| MS | $193.62 | — |
| MT | $193.62 | — |
| NC | $193.62 | — |
| ND | $193.62 | — |
| NE | $193.62 | — |
| NH | $220.94 | — |
| NJ | $258.16 | — |
| NM | $258.16 | — |
| NV | $249.14 | — |
| NY | $258.16 | — |
| OH | $258.16 | — |
| OK | $258.16 | — |
| OR | $211.42 | — |
| PA | $233.21 | — |
| PR | $387.16 | — |
| RI | $220.94 | — |
| SC | $193.62 | — |
| SD | $193.62 | — |
| TN | $193.62 | — |
| TX | $258.16 | — |
| UT | $193.62 | — |
| VA | $233.21 | — |
| VI | $258.16 | — |
| VT | $220.94 | — |
| WA | $211.42 | — |
| WI | $258.16 | — |
| WV | $233.21 | — |
| WY | $193.62 | — |
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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