V2628 HCPCS code: Fabrication and fitting of ocular conformer
V2628 is the HCPCS Level II code for fabrication and fitting of ocular conformer. The 2026 Medicare DMEPOS fee schedule pays $351.50 to $962.64 depending on the state. 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. Medicare volume fell 2% from 2022 to 2024 (3,749 to 3,660 services). In 2024, 99 suppliers billed Medicare for V2628 (purchases), serving 1,956 beneficiaries; California, Washington, New York accounted for 53% of services. Its average fee ranks 6 of 9 V26 codes (family range $82.57–$1,741.96).
Code details
| Field | Value |
|---|---|
| Section | V codes — Vision, hearing and speech-language pathology services |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1993-01-01 |
| Last action effective | 2003-10-01 |
2026 Medicare DMEPOS fee schedule for V2628
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $351.50 | $962.64 | $496.63 | $372.48 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $351.50 | — |
| AL | — | $400.90 | — |
| AR | — | $461.21 | — |
| AZ | — | $372.48 | — |
| CA | — | $372.48 | — |
| CO | — | $496.63 | — |
| CT | — | $372.48 | — |
| DC | — | $372.48 | — |
| DE | — | $372.48 | — |
| FL | — | $400.90 | — |
| GA | — | $400.90 | — |
| HI | — | $375.88 | — |
| IA | — | $496.63 | — |
| ID | — | $496.63 | — |
| IL | — | $372.48 | — |
| IN | — | $372.48 | — |
| KS | — | $496.63 | — |
| KY | — | $400.90 | — |
| LA | — | $461.21 | — |
| MA | — | $372.48 | — |
| MD | — | $372.48 | — |
| ME | — | $372.48 | — |
| MI | — | $372.48 | — |
| MN | — | $372.48 | — |
| MO | — | $496.63 | — |
| MS | — | $400.90 | — |
| MT | — | $496.63 | — |
| NC | — | $400.90 | — |
| ND | — | $496.63 | — |
| NE | — | $496.63 | — |
| NH | — | $372.48 | — |
| NJ | — | $378.33 | — |
| NM | — | $461.21 | — |
| NV | — | $372.48 | — |
| NY | — | $378.33 | — |
| OH | — | $372.48 | — |
| OK | — | $461.21 | — |
| OR | — | $496.63 | — |
| PA | — | $372.48 | — |
| PR | — | $962.64 | — |
| RI | — | $372.48 | — |
| SC | — | $400.90 | — |
| SD | — | $496.63 | — |
| TN | — | $400.90 | — |
| TX | — | $461.21 | — |
| UT | — | $496.63 | — |
| VA | — | $372.48 | — |
| VI | — | $378.33 | — |
| VT | — | $372.48 | — |
| WA | — | $496.63 | — |
| WI | — | $372.48 | — |
| WV | — | $372.48 | — |
| WY | — | $496.63 | — |
How the V2628 fee compares
| Measure | Value |
|---|---|
| Rank among 9 V26 codes (lowest = 1) | 6 |
| Family fee range (average of state fees) | $82.57–$1,741.96 |
| Rural fee uplift | — |
Who bills V2628 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 99 |
| Referring clinicians | 1,425 |
| Medicare beneficiaries | 1,956 |
| States with claims | 32 |
| Share of services in top 3 states (California, Washington, New York) | 53% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 103 | 2,171 |
| 2023 | 104 | 2,072 |
| 2024 | 99 | 1,956 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for V2628, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,749 | 2,171 | $346.87 | $266.98 |
| 2023 | 3,542 | 2,072 | $373.03 | $286.29 |
| 2024 | 3,660 | 1,956 | $388.09 | $298.36 |
States with the most V2628 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 971 | $274.85 |
| Washington | 608 | $367.06 |
| New York | 318 | $277.06 |
| Alaska | 253 | $264.40 |
| Florida | 235 | $293.30 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Nature of Service/Procedure |
| outpatient hospital claims | 2 | Nature of Service/Procedure |
What changed for V2628
- 2026-01-01: Average state fee rose 2.0%: $418.36 to $426.73
- 1993-01-01: V2628 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 V2628?
V2628 is the HCPCS Level II code for fabrication and fitting of ocular conformer. Short descriptor: "Fabrication & fitting".
How much does Medicare pay for V2628?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $351.50–$962.64. Rural fees can be higher.
Does Medicare cover V2628?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for V2628 change in 2026?
The average non-rural state fee moved from $418.36 in 2025 to $426.73 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of V2628 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related V26 codes
- V2600 — Hand held low vision aids and other nonspectacle mounted aids
- V2610 — Single lens spectacle mounted low vision aids
- V2615 — Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound microscopic lens system
- V2623 — Prosthetic eye, plastic, custom ($904.18–$1,984.14)
- V2624 — Polishing/resurfacing of ocular prosthesis ($44.45–$99.38)
- V2625 — Enlargement of ocular prosthesis ($370.98–$604.16)
- V2626 — Reduction of ocular prosthesis ($222.15–$357.61)
- V2627 — Scleral cover shell ($1,258.82–$2,103.31)
- V2629 — Prosthetic eye, other type
- V2630 — Anterior chamber intraocular lens ($145.73–$145.73)
- V2631 — Iris supported intraocular lens ($145.73–$145.73)
- V2632 — Posterior chamber intraocular lens ($145.73–$145.73)
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 V2628
- Watch V2628 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2628
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.