Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesVision ServicesHCPCS hcpcs-v2100-single-vision-sphere-lens-plano-to-plus-minus-4
    Ask Trek AI about this page

    HCPCS V2100: Single Vision Sphere Lens, Plano to ±4.00 per Lens

    HCPCS Level II code V2100 describes a single-vision spherical lens (plano to ±4.00) billed per lens for corrective eyewear; service type: ophthalmic lens provision/dispensing; typical site of service: optical shop, eye care clinic, or outpatient retail setting where prescription eyeglasses are fabricated and dispensed.

    For related coverage guidance, see recent payer policy updates: Evaluation of Dry Eyes, Evaluation of Dry Eyes, Ophthalmic Prostaglandin Analog Prior Authorization Criteria.

    Customize your policy alerts

    Sign up for hcpcs V2100 policy alerts

    Get alerted when payer policies referencing V2100 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old patient presents to an optometry clinic for routine refractive correction. After manifest refraction and visual acuity testing, the clinician determines the patient requires single-vision spectacle lenses with no spherical power (plano) to correct mild astigmatism or to provide plano reading lenses. The service corresponds to fabrication and dispensing of a single-vision spherical lens within the range plano to ±4.00 diopters per lens, billed under V2100. Typical workflow: patient registration and insurance verification; clinical refraction by an optometrist or ophthalmologist; lens selection and measurements (vertex distance, pupillary distance) by the dispensing technician; order entry to a optical lab or in-office lens finishing; verification and fitting appointment for frame mounting and patient education. Typical site of service is an outpatient optometry or ophthalmology clinic or an optical dispensary within a multispecialty ambulatory facility.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92015Determination of refractive state (refraction)Performed before ordering single-vision lenses to determine spherical power.
    92002Ophthalmological service: new patient, intermediate, with initiation of diagnostic services (new patient comprehensive ocular exam)Comprehensive exam that may precede lens prescription when medical eye disease is present.
    92004Ophthalmological service: comprehensive, established patient, initial comprehensive examComprehensive evaluation for established patients prior to dispensing corrective lenses.
    92340Spectacle lens, single vision, other than glass, per lensUsed for billing spectacle lenses in some payor systems; relates directly to fabrication/dispensing of single-vision lenses.
    92499Unlisted ophthalmological service/procedureUsed when specific lens services are not listed or for atypical lens fabrication procedures.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    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…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    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…
    3336C0002XClinic PharmacyA pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision o…
    225CA2400XAssistive Technology Practitioner Rehabilitation CounselorRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Rehabilitation Counselor
    103TP0814XPsychoanalysis PsychologistA psychologist whose specialty is distinguished from other specialties by its body of knowledge and its intensive treatment approaches. It aims at str…
    171W00000XContractorFor the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patie…
    103K00000XBehavior AnalystA behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …
    207YP0228XPediatric Otolaryngology PhysicianA pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired condi…
    332B00000XDurable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…

    Related Payer Policy Updates

    Specialty: Ophthalmology/Optometry1 / 2

    10 rows

    PolicyPayerEffective Date
    Evaluation of Dry EyesOscar Health2026-10-01
    Evaluation of Dry EyesBlue Cross Blue Shield - New Mexico2026-09-04
    Ophthalmic Prostaglandin Analog Prior Authorization Criteriamedimpact2026-09-01
    revakinagene taroretcel-lwey (Encelto) coverage for idiopathic macular telangiectasia (MacTel) type 2blue cross blue shield - louisiana2026-09-01
    Glaucoma ProstaglandinsCigna2026-08-15
    Corneal Cross‑linking (CXL) Procedurehusky_health2026-08-01
    Corneal surgical procedures (excluding corneal collagen cross-linking)husky_health2026-08-01
    Intracanalicular and Intravitreal Corticosteroid ImplantsUnitedHealthcare2026-08-01
    Eye Optical Coherence TomographyPremera Bluecross2026-08-01
    Susvimo (ranibizumab) intravitreal implant — Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    HCPCS-LEVEL-II-V2211-SPHEROCYLINDER-BIFOCAL-HIGH-SPHERE

    HCPCS Level II V2211: Spherocylinder Bifocal Lens, High Sphere Range

    HCPCS-LEVEL-II-V2700-BALANCE-LENS-PER-LENS

    HCPCS Level II V2700: Balance Lens, Per Lens

    HCPCS-V2020-FRAMES-PURCHASES

    HCPCS Level II V2020: Frames, Purchases

    HCPCS-V2025-DELUXE-FRAME-VISION-APPLIANCE

    HCPCS V2025: Deluxe Frame

    HCPCS-V2101-SINGLE-VISION-SPHERICAL-LENS-HIGH-POWER

    HCPCS Level II V2101: Sphere Single Vision High-Power Lens

    HCPCS-V2102-HIGH-POWER-SINGLE-VISION-SPHERICAL-LENS

    HCPCS V2102: Single-Vision High-Power Spherical Lens

    HCPCS-V2103-SPHEROCYLINDER-SINGLE-VISION-LENS

    HCPCS Level II V2103: Single-Vision Spherocylinder Lens, Per Lens

    HCPCS-V2104-SPHEROCYLINDER-SINGLE-VISION-LENS-PLANO-TO-4D-SPHERE-2-12-TO-4D-CYLINDER

    HCPCS V2104: Spherocylinder Single-Vision Lens, Per Lens

    HCPCS-V2105-SPHEROCYLINDER-SINGLE-VISION-LENS

    HCPCS Level II V2105: Spherocylinder Single-Vision Lens

    HCPCS-V2106-SINGLE-VISION-SPHEROCYLINDER-HIGH-ASTIGMATISM-LENS

    HCPCS Level II V2106: Spherocylinder Single-Vision Lens, High Cylinder

    Showing 1–10 of 123

    • More pages

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.