V2715 HCPCS code: Prism, per lens
V2715 is the HCPCS Level II code for prism, per lens. The 2026 Medicare DMEPOS fee schedule pays $14.23 to $97.78 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 4 per day on DME suppliers. Medicare volume fell 21% from 2022 to 2024 (3,787 to 2,983 services). In 2024, 874 suppliers billed Medicare for V2715 (purchases), serving 1,623 beneficiaries; Kansas, Indiana, Pennsylvania accounted for 24% of services. Its average fee ranks 3 of 16 V27 codes (family range $14.12–$91.34).
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 | 1985-01-01 |
| Last action effective | 2003-10-01 |
2026 Medicare DMEPOS fee schedule for V2715
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $14.23 | $97.78 | $18.98 | $14.23 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $28.82 | — |
| AL | — | $14.23 | — |
| AR | — | $16.08 | — |
| AZ | — | $18.98 | — |
| CA | — | $18.98 | — |
| CO | — | $14.23 | — |
| CT | — | $14.23 | — |
| DC | — | $15.06 | — |
| DE | — | $15.06 | — |
| FL | — | $14.23 | — |
| GA | — | $14.23 | — |
| HI | — | $30.88 | — |
| IA | — | $16.31 | — |
| ID | — | $17.49 | — |
| IL | — | $17.65 | — |
| IN | — | $17.65 | — |
| KS | — | $16.31 | — |
| KY | — | $14.23 | — |
| LA | — | $16.08 | — |
| MA | — | $14.23 | — |
| MD | — | $15.06 | — |
| ME | — | $14.23 | — |
| MI | — | $17.65 | — |
| MN | — | $17.65 | — |
| MO | — | $16.31 | — |
| MS | — | $14.23 | — |
| MT | — | $14.23 | — |
| NC | — | $14.23 | — |
| ND | — | $14.23 | — |
| NE | — | $16.31 | — |
| NH | — | $14.23 | — |
| NJ | — | $18.98 | — |
| NM | — | $16.08 | — |
| NV | — | $18.98 | — |
| NY | — | $18.98 | — |
| OH | — | $17.65 | — |
| OK | — | $16.08 | — |
| OR | — | $17.49 | — |
| PA | — | $15.06 | — |
| PR | — | $97.78 | — |
| RI | — | $14.23 | — |
| SC | — | $14.23 | — |
| SD | — | $14.23 | — |
| TN | — | $14.23 | — |
| TX | — | $16.08 | — |
| UT | — | $14.23 | — |
| VA | — | $15.06 | — |
| VI | — | $18.98 | — |
| VT | — | $14.23 | — |
| WA | — | $17.49 | — |
| WI | — | $17.65 | — |
| WV | — | $15.06 | — |
| WY | — | $14.23 | — |
How the V2715 fee compares
| Measure | Value |
|---|---|
| Rank among 16 V27 codes (lowest = 1) | 3 |
| Family fee range (average of state fees) | $14.12–$91.34 |
| Rural fee uplift | — |
Who bills V2715 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 874 |
| Referring clinicians | 1,177 |
| Medicare beneficiaries | 1,623 |
| States with claims | 33 |
| Share of services in top 3 states (Kansas, Indiana, Pennsylvania) | 24% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,013 | 2,038 |
| 2023 | 1,012 | 1,927 |
| 2024 | 874 | 1,623 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for V2715, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,787 | 2,038 | $11.53 | $8.79 |
| 2023 | 3,561 | 1,927 | $11.91 | $9.08 |
| 2024 | 2,983 | 1,623 | $12.37 | $9.45 |
States with the most V2715 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Kansas | 255 | $8.19 |
| Indiana | 207 | $10.63 |
| Pennsylvania | 198 | $9.77 |
| Wisconsin | 184 | $9.70 |
| Florida | 171 | $8.92 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 4 | Clinical: Data |
| outpatient hospital claims | 4 | Clinical: Data |
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 V2715
- 2026-01-01: Average state fee rose 2.0%: $17.58 to $17.93
- 1985-01-01: V2715 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 V2715?
V2715 is the HCPCS Level II code for prism, per lens. Short descriptor: "Prism lens/es".
How much does Medicare pay for V2715?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $14.23–$97.78. Rural fees can be higher.
Does Medicare cover V2715?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for V2715?
Medicare policy articles that cite V2715 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 V2715 change in 2026?
The average non-rural state fee moved from $17.58 in 2025 to $17.93 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of V2715 can be billed per day?
4 on DME suppliers; 4 on outpatient hospital claims (NCCI medically unlikely edits).
Related V27 codes
- V2700 — Balance lens, per lens ($53.63–$99.58)
- V2702 — Deluxe lens feature
- V2710 — Slab off prism, glass or plastic, per lens ($78.50–$154.85)
- V2718 — Press-on lens, fresnell prism, per lens ($34.95–$96.72)
- V2730 — Special base curve, glass or plastic, per lens ($7.60–$37.36)
- V2744 — Tint, photochromatic, per lens ($15.43–$26.78)
- V2745 — Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens ($12.57–$16.76)
- V2750 — Anti-reflective coating, per lens ($23.37–$48.05)
- V2755 — U-v lens, per lens ($14.47–$27.11)
- V2756 — Eye glass case
- V2760 — Scratch resistant coating, per lens ($10.06–$36.57)
- V2761 — Mirror coating, any type, solid, gradient or equal, any lens material, per lens
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 V2715
- Watch V2715 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V2715
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.