V2199 HCPCS code: Not otherwise classified, single vision lens
V2199 is the HCPCS Level II code for not otherwise classified, single vision lens. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | V codes — Vision, hearing and speech-language pathology services |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 46 — Priced by the Medicare contractor (no national fee) |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1985-01-01 |
| Last action effective | 2003-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Nature of Equipment |
| outpatient hospital claims | 2 | Nature of Equipment |
| practitioner claims | 2 | Nature of Equipment |
Medicare policy articles for this code
- A52499: Refractive Lenses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (6 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| H27.00 | Aphakia, unspecified eye | 1 |
| H27.01 | Aphakia, right eye | 1 |
| H27.02 | Aphakia, left eye | 1 |
| H27.03 | Aphakia, bilateral | 1 |
| Q12.3 | Congenital aphakia | 1 |
| Z96.1 | Presence of intraocular lens | 1 |
What changed for V2199
- 1985-01-01: V2199 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code V2199?
V2199 is the HCPCS Level II code for not otherwise classified, single vision lens. Short descriptor: "Lens single vision not oth c".
Does Medicare cover V2199?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for V2199?
Medicare policy articles that cite V2199 list 6 covered ICD-10-CM diagnosis codes across 1 article. The most cited include H27.00 (Aphakia, unspecified eye), H27.01 (Aphakia, right eye), H27.02 (Aphakia, left eye). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of V2199 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related V21 codes
- V2100 — Sphere, single vision, plano to plus or minus 4.00, per lens ($45.07–$63.95)
- V2101 — Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens ($50.53–$72.86)
- V2102 — Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens ($58.09–$94.77)
- V2103 — Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens ($41.63–$58.09)
- V2104 — Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens ($46.12–$61.49)
- V2105 — Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens ($50.21–$66.95)
- V2106 — Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ($55.71–$74.29)
- V2107 — Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens ($52.98–$77.70)
- V2108 — Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens ($54.87–$73.24)
- V2109 — Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens ($58.09–$84.48)
- V2110 — Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens ($58.09–$79.86)
- V2111 — Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ($62.44–$84.49)
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Next steps
- Run a reimbursement report for a device billed under V2199
- Watch V2199 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2199
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.