V2221 HCPCS code: Lenticular lens, per lens, bifocal
V2221 is the HCPCS Level II code for lenticular lens, per lens, bifocal. The 2026 Medicare DMEPOS fee schedule pays $108.14 to $225.51 depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 2 per day on DME suppliers. Medicare volume fell 68% from 2022 to 2023 (131 to 42 services). In 2023, 4 suppliers billed Medicare for V2221 (purchases), serving 19 beneficiaries. Its average fee ranks 19 of 20 V22 codes (family range $52.13–$138.51).
Code details
| Field | Value |
|---|---|
| Section | V codes — Vision, hearing and speech-language pathology services |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2004-01-01 |
| Last action effective | 2004-01-01 |
2026 Medicare DMEPOS fee schedule for V2221
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $108.14 | $225.51 | $144.18 | $108.14 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $210.92 | — |
| AL | — | $118.11 | — |
| AR | — | $123.13 | — |
| AZ | — | $144.18 | — |
| CA | — | $144.18 | — |
| CO | — | $111.54 | — |
| CT | — | $130.13 | — |
| DC | — | $116.00 | — |
| DE | — | $116.00 | — |
| FL | — | $118.11 | — |
| GA | — | $118.11 | — |
| HI | — | $225.51 | — |
| IA | — | $108.14 | — |
| ID | — | $118.59 | — |
| IL | — | $108.14 | — |
| IN | — | $108.14 | — |
| KS | — | $108.14 | — |
| KY | — | $118.11 | — |
| LA | — | $123.13 | — |
| MA | — | $130.13 | — |
| MD | — | $116.00 | — |
| ME | — | $130.13 | — |
| MI | — | $108.14 | — |
| MN | — | $108.14 | — |
| MO | — | $108.14 | — |
| MS | — | $118.11 | — |
| MT | — | $111.54 | — |
| NC | — | $118.11 | — |
| ND | — | $111.54 | — |
| NE | — | $108.14 | — |
| NH | — | $130.13 | — |
| NJ | — | $118.37 | — |
| NM | — | $123.13 | — |
| NV | — | $144.18 | — |
| NY | — | $118.37 | — |
| OH | — | $108.14 | — |
| OK | — | $123.13 | — |
| OR | — | $118.59 | — |
| PA | — | $116.00 | — |
| PR | — | $123.21 | — |
| RI | — | $130.13 | — |
| SC | — | $118.11 | — |
| SD | — | $111.54 | — |
| TN | — | $118.11 | — |
| TX | — | $123.13 | — |
| UT | — | $111.54 | — |
| VA | — | $116.00 | — |
| VI | — | $118.40 | — |
| VT | — | $130.13 | — |
| WA | — | $118.59 | — |
| WI | — | $108.14 | — |
| WV | — | $116.00 | — |
| WY | — | $111.54 | — |
How the V2221 fee compares
| Measure | Value |
|---|---|
| Rank among 20 V22 codes (lowest = 1) | 19 |
| Family fee range (average of state fees) | $52.13–$138.51 |
| Rural fee uplift | — |
Who bills V2221 (2023)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 4 |
| Referring clinicians | 5 |
| Medicare beneficiaries | 19 |
| States with claims | 1 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 10 | 58 |
| 2023 | 4 | 19 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for V2221, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 131 | 58 | $99.70 | $77.84 |
| 2023 | 42 | 19 | $108.11 | $81.57 |
States with the most V2221 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| New York | 39 | $81.30 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
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 V2221
- 2026-01-01: Average state fee rose 2.0%: $120.07 to $122.47
- 2004-01-01: V2221 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 V2221?
V2221 is the HCPCS Level II code for lenticular lens, per lens, bifocal. Short descriptor: "Lenticular lens, bifocal".
How much does Medicare pay for V2221?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $108.14–$225.51. Rural fees can be higher.
Does Medicare cover V2221?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for V2221?
Medicare policy articles that cite V2221 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.
Did the Medicare fee for V2221 change in 2026?
The average non-rural state fee moved from $120.07 in 2025 to $122.47 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of V2221 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related V22 codes
- V2200 — Sphere, bifocal, plano to plus or minus 4.00d, per lens ($62.77–$83.69)
- V2201 — Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens ($68.41–$97.51)
- V2202 — Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens ($72.09–$107.33)
- V2203 — Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens ($63.32–$85.46)
- V2204 — Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens ($66.79–$88.26)
- V2205 — Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens ($71.57–$95.43)
- V2206 — Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ($72.09–$102.53)
- V2207 — Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens ($69.95–$94.02)
- V2208 — Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens ($72.09–$104.60)
- V2209 — Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens ($72.09–$103.98)
- V2210 — Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens ($72.09–$116.25)
- V2211 — Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ($90.41–$131.58)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under V2221
- Watch V2221 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2221
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026; 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.