V2499 HCPCS code: Variable sphericity lens, other type
V2499 is the HCPCS Level II code for variable sphericity lens, other type. 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 | 1984-01-01 |
| 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 V2499
- 1984-01-01: V2499 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 V2499?
V2499 is the HCPCS Level II code for variable sphericity lens, other type. Short descriptor: "Variable asphericity lens".
Does Medicare cover V2499?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for V2499?
Medicare policy articles that cite V2499 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 V2499 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related V24 codes
- V2410 — Variable asphericity lens, single vision, full field, glass or plastic, per lens ($109.77–$172.48)
- V2430 — Variable asphericity lens, bifocal, full field, glass or plastic, per lens ($132.29–$251.95)
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Next steps
- Run a reimbursement report for a device billed under V2499
- Watch V2499 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2499
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.