V2715 — Prism, per lens
HCPCS Level II V-code · short descriptor: “Prism lens/es”
- 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.
V2715 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $14.23 to $97.78 depending on state and rural status.
Former-CBA payment limits: ceiling $18.98 · floor $14.23
| State | Non-rural | Rural |
|---|---|---|
| AK | $28.82 | — |
| AL | $14.23 | — |
| AR | $16.08 | — |
| AZ | $18.98 | — |
| CA | $18.98 | — |
| CO | $14.23 | — |
| CT | $14.23 | — |
| DC | $15.06 | — |
| DE | $15.06 | — |
| FL | $14.23 | — |
| GA | $14.23 | — |
| HI | $30.88 | — |
| IA | $16.31 | — |
| ID | $17.49 | — |
| IL | $17.65 | — |
| IN | $17.65 | — |
| KS | $16.31 | — |
| KY | $14.23 | — |
| LA | $16.08 | — |
| MA | $14.23 | — |
| MD | $15.06 | — |
| ME | $14.23 | — |
| MI | $17.65 | — |
| MN | $17.65 | — |
| MO | $16.31 | — |
| MS | $14.23 | — |
| MT | $14.23 | — |
| NC | $14.23 | — |
| ND | $14.23 | — |
| NE | $16.31 | — |
| NH | $14.23 | — |
| NJ | $18.98 | — |
| NM | $16.08 | — |
| NV | $18.98 | — |
| NY | $18.98 | — |
| OH | $17.65 | — |
| OK | $16.08 | — |
| OR | $17.49 | — |
| PA | $15.06 | — |
| PR | $97.78 | — |
| RI | $14.23 | — |
| SC | $14.23 | — |
| SD | $14.23 | — |
| TN | $14.23 | — |
| TX | $16.08 | — |
| UT | $14.23 | — |
| VA | $15.06 | — |
| VI | $18.98 | — |
| VT | $14.23 | — |
| WA | $17.49 | — |
| WI | $17.65 | — |
| WV | $15.06 | — |
| WY | $14.23 | — |
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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