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    v1.0.28
    OpenPayerBilling CodesTemporary National Codes (Non-Medicare)HCPCS hcpcs-s0580-polycarbonate-lens
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    HCPCS Level II S0580: Polycarbonate Lens (add-on)

    HCPCS Level II code S0580 denotes a polycarbonate lens and is reported in addition to the basic lens code when a polycarbonate material is provided; the service is an optical/prosthetic lens supply typically furnished in outpatient ophthalmology or optometry settings such as eye clinics or optical dispensaries.

    For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for New Mexico Only).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with a history of traumatic eye injury presents to an ophthalmology ambulatory surgery center for intraocular lens replacement following cataract extraction. The surgeon selects a polycarbonate intraocular lens for its impact resistance and optics. The facility bills the primary intraocular lens code for the basic lens implant and lists S0580 in addition to the basic lens code to indicate the polycarbonate material. Typical workflow: preoperative evaluation by ophthalmology, confirmation of lens selection in the operative note, implantation of the lens during the cataract procedure, and facility billing that includes the basic lens CPT for the implant plus S0580 to identify the polycarbonate lens material. Typical site of service is an ambulatory surgery center or hospital outpatient department. Common patient indications include traumatic lens damage, high-risk of ocular impact, or patient preference for impact-resistant lens material.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    66984Extracapsular cataract removal with insertion of intraocular lens (one-stage procedure), complexCommon primary surgical CPT for cataract extraction with lens implantation where a polycarbonate lens (billed with S0580) may be used.
    66982Extracapsular cataract removal with insertion of intraocular lens (one-stage procedure), complex (e.g., significant trauma, retained lens fragments)Used for complex cataract cases such as traumatic eyes where a polycarbonate lens is chosen for impact resistance; S0580 is appended in facility billing for the lens material.
    01916Anesthesia for ophthalmologic intravitreal procedures and the anterior segment of the eyeRepresents anesthesia services that may be provided during cataract/lens implantation procedures and billed alongside facility reporting of S0580.
    66920Removal of lens material; intracapsular (for certain complicated cases)May precede implantation of an intraocular lens where the facility later bills S0580 for a polycarbonate lens implant.
    92083Extended ophthalmological diagnostic and treatment services, with retinoscopy and keratometryPreoperative diagnostic and biometry testing commonly performed prior to selection of the intraocular lens material and power; supports clinical necessity for S0580.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    1PModifier 1P is a Category II performance measure exclusion modifier used to indicate that a patient’s medical condition prevented performance of the action specified by a Category II quality measure…- Use modifier 1P only with Category II (quality reporting) codes when the specific measure’s reporting instructions explicitly allow a medical-reason exclusion; it marks the patient as medically…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207W00000XOphthalmology PhysicianAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    208100000XPhysical Medicine & Rehabilitation PhysicianPhysical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and…
    364SX0106XOccupational Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    225C00000XRehabilitation CounselorAn individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabil…
    174400000XSpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
    363LF0000XFamily Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    2084N0400XNeurology PhysicianA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    10 rows

    PolicyPayerEffective Date
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01
    Clinical Policy: Air AmbulanceArizona Complete Health2026-08-01
    Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceAmbetter Nevada2026-08-01
    Ambulance TransportProvidence Health Plan2026-07-01
    Air ambulance transport coverage criteriaeocco2026-07-01

    Related Codes

    HCPCS-LEVEL-II-S2152-SOLID-ORGAN-TRANSPLANTATION-GLOBAL-CARE

    HCPCS Level II S2152: Solid Organ Procurement and Transplantation

    HCPCS-LEVEL-II-S2266-INDUCED-ABORTION-29-TO-31-WEEKS

    HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks

    HCPCS-LEVEL-II-S3630-EOSINOPHIL-COUNT-BLOOD-DIRECT

    HCPCS Level II S3630: Eosinophil Count, Blood, Direct

    HCPCS-LEVEL-II-S4017-INCOMPLETE-ART-CYCLE-CANCELLED-PRIOR-TO-STIMULATION

    HCPCS Level II S4017: Incomplete Cycle — Cancelled Prior to Stimulation

    HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

    HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction

    HCPCS-LEVEL-II-S8940-EQUESTRIAN-HIPPOTHERAPY-PER-SESSION

    HCPCS Level II S8940: Equestrian/Hippotherapy, Per Session

    HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

    HCPCS Level II S9024: Paranasal Sinus Ultrasound

    HCPCS-LEVEL-II-S9366-HOME-TPN-1-2L-PER-DAY-HOME-INFUSION

    HCPCS Level II S9366: Home Infusion TPN, 1–2 L/day

    HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

    HCPCS S9446: Patient Education, Non-Physician Provider, Group, Per Session

    HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

    HCPCS S9451: Exercise Classes, Non-Physician Provider, Per Session

    Showing 1–10 of 532

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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