V2523 HCPCS code: Contact lens, hydrophilic, extended wear, per lens
V2523 is the HCPCS Level II code for contact lens, hydrophilic, extended wear, per lens. The 2026 Medicare DMEPOS fee schedule pays $178.06 to $388.84 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 49% from 2022 to 2024 (99 to 50 services). In 2024, 17 suppliers billed Medicare for V2523 (purchases), serving 24 beneficiaries. Its average fee ranks 7 of 15 V25 codes (family range $118.70–$668.43).
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 | 1985-01-01 |
| Last action effective | 2003-10-01 |
2026 Medicare DMEPOS fee schedule for V2523
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $178.06 | $388.84 | $245.80 | $184.35 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $178.06 | — |
| AL | — | $184.35 | — |
| AR | — | $225.33 | — |
| AZ | — | $184.35 | — |
| CA | — | $184.35 | — |
| CO | — | $184.35 | — |
| CT | — | $238.20 | — |
| DC | — | $231.23 | — |
| DE | — | $231.23 | — |
| FL | — | $184.35 | — |
| GA | — | $184.35 | — |
| HI | — | $190.37 | — |
| IA | — | $187.02 | — |
| ID | — | $188.26 | — |
| IL | — | $227.73 | — |
| IN | — | $227.73 | — |
| KS | — | $187.02 | — |
| KY | — | $184.35 | — |
| LA | — | $225.33 | — |
| MA | — | $238.20 | — |
| MD | — | $231.23 | — |
| ME | — | $238.20 | — |
| MI | — | $227.73 | — |
| MN | — | $227.73 | — |
| MO | — | $187.02 | — |
| MS | — | $184.35 | — |
| MT | — | $184.35 | — |
| NC | — | $184.35 | — |
| ND | — | $184.35 | — |
| NE | — | $187.02 | — |
| NH | — | $238.20 | — |
| NJ | — | $229.77 | — |
| NM | — | $225.33 | — |
| NV | — | $184.35 | — |
| NY | — | $229.77 | — |
| OH | — | $227.73 | — |
| OK | — | $225.33 | — |
| OR | — | $188.26 | — |
| PA | — | $231.23 | — |
| PR | — | $388.84 | — |
| RI | — | $238.20 | — |
| SC | — | $184.35 | — |
| SD | — | $184.35 | — |
| TN | — | $184.35 | — |
| TX | — | $225.33 | — |
| UT | — | $184.35 | — |
| VA | — | $231.23 | — |
| VI | — | $229.77 | — |
| VT | — | $238.20 | — |
| WA | — | $188.26 | — |
| WI | — | $227.73 | — |
| WV | — | $231.23 | — |
| WY | — | $184.35 | — |
How the V2523 fee compares
| Measure | Value |
|---|---|
| Rank among 15 V25 codes (lowest = 1) | 7 |
| Family fee range (average of state fees) | $118.70–$668.43 |
| Rural fee uplift | — |
Who bills V2523 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 17 |
| Referring clinicians | 21 |
| Medicare beneficiaries | 24 |
| States with claims | 1 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 31 | 51 |
| 2023 | 29 | 47 |
| 2024 | 17 | 24 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for V2523, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 99 | 51 | $133.95 | $99.91 |
| 2023 | 86 | 47 | $157.28 | $117.79 |
| 2024 | 50 | 24 | $165.84 | $114.18 |
States with the most V2523 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Arizona | 15 | $129.36 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
| practitioner 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 V2523
- 2026-01-01: Average state fee rose 2.0%: $207.23 to $211.38
- 1985-01-01: V2523 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 V2523?
V2523 is the HCPCS Level II code for contact lens, hydrophilic, extended wear, per lens. Short descriptor: "Cntct lens hydrophil extend".
How much does Medicare pay for V2523?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $178.06–$388.84. Rural fees can be higher.
Does Medicare cover V2523?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for V2523?
Medicare policy articles that cite V2523 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 V2523 change in 2026?
The average non-rural state fee moved from $207.23 in 2025 to $211.38 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of V2523 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related V25 codes
- V2500 — Contact lens, pmma, spherical, per lens ($99.50–$387.16)
- V2501 — Contact lens, pmma, toric or prism ballast, per lens ($151.57–$435.59)
- V2502 — Contact lens, pmma, bifocal, per lens ($186.72–$434.08)
- V2503 — Contact lens, pmma, color vision deficiency, per lens ($171.97–$241.70)
- V2510 — Contact lens, gas permeable, spherical, per lens ($135.83–$387.16)
- V2511 — Contact lens, gas permeable, toric, prism ballast, per lens ($195.17–$434.08)
- V2512 — Contact lens, gas permeable, bifocal, per lens ($230.62–$434.08)
- V2513 — Contact lens, gas permeable, extended wear, per lens ($193.62–$387.16)
- V2520 — Contact lens, hydrophilic, spherical, per lens ($119.79–$387.16)
- V2521 — Contact lens, hydrophilic, toric, or prism ballast, per lens ($214.82–$435.59)
- V2522 — Contact lens, hydrophilic, bifocal, per lens ($216.33–$435.59)
- V2524 — Contact lens, hydrophilic, spherical, photochromic additive, per lens ($135.23–$402.59)
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 V2523
- Watch V2523 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2523
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.