V2321 HCPCS code: Lenticular lens, per lens, trifocal
V2321 is the HCPCS Level II code for lenticular lens, per lens, trifocal. The 2026 Medicare DMEPOS fee schedule pays $143.98 to $211.38 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. Its average fee ranks 18 of 20 V23 codes (family range $65.79–$210.73).
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 V2321
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $143.98 | $211.38 | $191.98 | $143.98 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $197.66 | — |
| AL | — | $191.98 | — |
| AR | — | $145.66 | — |
| AZ | — | $178.47 | — |
| CA | — | $178.47 | — |
| CO | — | $143.98 | — |
| CT | — | $191.98 | — |
| DC | — | $143.98 | — |
| DE | — | $143.98 | — |
| FL | — | $191.98 | — |
| GA | — | $191.98 | — |
| HI | — | $211.38 | — |
| IA | — | $143.98 | — |
| ID | — | $143.98 | — |
| IL | — | $143.98 | — |
| IN | — | $143.98 | — |
| KS | — | $143.98 | — |
| KY | — | $191.98 | — |
| LA | — | $145.66 | — |
| MA | — | $191.98 | — |
| MD | — | $143.98 | — |
| ME | — | $191.98 | — |
| MI | — | $143.98 | — |
| MN | — | $143.98 | — |
| MO | — | $143.98 | — |
| MS | — | $191.98 | — |
| MT | — | $143.98 | — |
| NC | — | $191.98 | — |
| ND | — | $143.98 | — |
| NE | — | $143.98 | — |
| NH | — | $191.98 | — |
| NJ | — | $174.14 | — |
| NM | — | $145.66 | — |
| NV | — | $178.47 | — |
| NY | — | $174.14 | — |
| OH | — | $143.98 | — |
| OK | — | $145.66 | — |
| OR | — | $143.98 | — |
| PA | — | $143.98 | — |
| PR | — | $185.42 | — |
| RI | — | $191.98 | — |
| SC | — | $191.98 | — |
| SD | — | $143.98 | — |
| TN | — | $191.98 | — |
| TX | — | $145.66 | — |
| UT | — | $143.98 | — |
| VA | — | $143.98 | — |
| VI | — | $174.19 | — |
| VT | — | $191.98 | — |
| WA | — | $143.98 | — |
| WI | — | $143.98 | — |
| WV | — | $143.98 | — |
| WY | — | $143.98 | — |
How the V2321 fee compares
| Measure | Value |
|---|---|
| Rank among 20 V23 codes (lowest = 1) | 18 |
| Family fee range (average of state fees) | $65.79–$210.73 |
| Rural fee uplift | — |
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 V2321
- 2026-01-01: Average state fee rose 2.0%: $160.34 to $163.54
- 2004-01-01: V2321 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 V2321?
V2321 is the HCPCS Level II code for lenticular lens, per lens, trifocal. Short descriptor: "Lenticular lens, trifocal".
How much does Medicare pay for V2321?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $143.98–$211.38. Rural fees can be higher.
Does Medicare cover V2321?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for V2321?
Medicare policy articles that cite V2321 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 V2321 change in 2026?
The average non-rural state fee moved from $160.34 in 2025 to $163.54 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of V2321 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related V23 codes
- V2300 — Sphere, trifocal, plano to plus or minus 4.00d, per lens ($79.89–$103.21)
- V2301 — Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens ($94.18–$123.97)
- V2302 — Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens ($81.52–$133.86)
- V2303 — Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens ($78.62–$105.79)
- V2304 — Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens ($82.40–$110.37)
- V2305 — Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens ($95.32–$120.27)
- V2306 — Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ($98.15–$130.86)
- V2307 — Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens ($92.92–$120.27)
- V2308 — Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens ($97.38–$123.90)
- V2309 — Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens ($98.71–$144.96)
- V2310 — Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens ($98.71–$139.77)
- V2311 — Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ($109.08–$152.73)
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Next steps
- Run a reimbursement report for a device billed under V2321
- Watch V2321 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2321
Sources: CMS HCPCS Level II release October 2025; 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.