V2531 HCPCS code: Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)
V2531 is the HCPCS Level II code for contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325). The 2026 Medicare DMEPOS fee schedule pays $650.75 to $715.83 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 21% from 2022 to 2024 (137 to 108 services). In 2024, 45 suppliers billed Medicare for V2531 (purchases), serving 79 beneficiaries. Its average fee ranks 15 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 | 1996-01-01 |
| Last action effective | 2003-10-01 |
2026 Medicare DMEPOS fee schedule for V2531
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $650.75 | $715.83 | $799.22 | $599.42 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $657.26 | — |
| AL | — | $670.31 | — |
| AR | — | $670.24 | — |
| AZ | — | $650.75 | — |
| CA | — | $650.75 | — |
| CO | — | $671.91 | — |
| CT | — | $683.61 | — |
| DC | — | $650.75 | — |
| DE | — | $650.75 | — |
| FL | — | $670.31 | — |
| GA | — | $670.31 | — |
| HI | — | $702.81 | — |
| IA | — | $662.80 | — |
| ID | — | $650.75 | — |
| IL | — | $666.71 | — |
| IN | — | $666.71 | — |
| KS | — | $662.80 | — |
| KY | — | $670.31 | — |
| LA | — | $670.24 | — |
| MA | — | $683.61 | — |
| MD | — | $650.75 | — |
| ME | — | $683.61 | — |
| MI | — | $666.71 | — |
| MN | — | $666.71 | — |
| MO | — | $662.80 | — |
| MS | — | $670.31 | — |
| MT | — | $671.91 | — |
| NC | — | $670.31 | — |
| ND | — | $671.91 | — |
| NE | — | $662.80 | — |
| NH | — | $683.61 | — |
| NJ | — | $663.82 | — |
| NM | — | $670.24 | — |
| NV | — | $650.75 | — |
| NY | — | $663.82 | — |
| OH | — | $666.71 | — |
| OK | — | $670.24 | — |
| OR | — | $650.75 | — |
| PA | — | $650.75 | — |
| PR | — | $715.83 | — |
| RI | — | $683.61 | — |
| SC | — | $670.31 | — |
| SD | — | $671.91 | — |
| TN | — | $670.31 | — |
| TX | — | $670.24 | — |
| UT | — | $671.91 | — |
| VA | — | $650.75 | — |
| VI | — | $715.83 | — |
| VT | — | $683.61 | — |
| WA | — | $650.75 | — |
| WI | — | $666.71 | — |
| WV | — | $650.75 | — |
| WY | — | $671.91 | — |
How the V2531 fee compares
| Measure | Value |
|---|---|
| Rank among 15 V25 codes (lowest = 1) | 15 |
| Family fee range (average of state fees) | $118.70–$668.43 |
| Rural fee uplift | — |
Who bills V2531 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 45 |
| Referring clinicians | 55 |
| Medicare beneficiaries | 79 |
| States with claims | 1 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 49 | 98 |
| 2023 | 48 | 85 |
| 2024 | 45 | 79 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for V2531, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 137 | 98 | $471.54 | $367.38 |
| 2023 | 116 | 85 | $493.53 | $382.83 |
| 2024 | 108 | 79 | $515.47 | $397.44 |
States with the most V2531 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Oregon | 14 | $423.36 |
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
- A52462: Eye Prostheses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- 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 V2531
- 2026-01-01: Average state fee rose 2.0%: $655.32 to $668.43
- 1996-01-01: V2531 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 V2531?
V2531 is the HCPCS Level II code for contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325). Short descriptor: "Contact lens gas permeable".
How much does Medicare pay for V2531?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $650.75–$715.83. Rural fees can be higher.
Does Medicare cover V2531?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for V2531?
Medicare policy articles that cite V2531 list 6 covered ICD-10-CM diagnosis codes across 2 articles. 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 V2531 change in 2026?
The average non-rural state fee moved from $655.32 in 2025 to $668.43 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of V2531 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital 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)
- V2523 — Contact lens, hydrophilic, extended wear, per lens ($178.06–$388.84)
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 V2531
- Watch V2531 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2531
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.