Summary & Overview
HCPCS V2105: Spherocylinder Single-Vision Lens (per lens)
HCPCS Level II code V2105 identifies a spherocylinder single-vision eyeglass lens with spherical power from plano to ±4.00 diopters and cylindrical power between 4.25 and 6.00 diopters, billed per lens. This product-level code matters nationally because it standardizes billing for a common class of prescription corrective lenses used in routine vision correction and optical dispensing, supporting consistent claims submission and benefit administration across commercial and federal payers.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on the code's clinical and product characteristics, the typical service setting for provision, and which payers commonly process claims for this type of lens. The publication also outlines benchmark elements and policy considerations relevant to vision benefit coverage and billing practice. Where input data is unavailable, the text notes that information is not provided.
This summary provides clinicians, billing staff, and payers a clear, national-level reference for identifying the service described by V2105, understanding its role in optical care delivery, and anticipating the administrative context for reimbursement and claims processing.
Billing Code Overview
HCPCS Level II code V2105 describes a spherocylinder single-vision lens specified for sphere powers from plano to ±4.00 diopters and cylinder powers from 4.25 to 6.00 diopters, billed per lens. This code represents an eyeglass lens product with combined spherical and cylindrical correction in a single-vision configuration.
Service Type: Ophthalmic lens provision / optical dispensing
Typical Site of Service: Optical dispensary or vision care clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to an optometry or ophthalmology clinic for a routine refractive evaluation because of progressive blur and astigmatic symptoms. Manifest refraction reveals a spherocylindrical refractive error requiring a single-vision spectacle lens with spherical power within plano to ±4.00 diopters and cylinder power between 4.25 and 6.00 diopters. The optical laboratory is instructed to fabricate a single-vision spectacle lens (per lens) using the specified parameters. Typical workflow: patient examination and refraction by an optometrist or ophthalmologist; documentation of refractive error and visual acuity; prescription generation specifying sphere and cylinder values; transmission of lens order to on-site or external optical lab; fabrication and dispensing with final fitting and verification of visual function. Typical site of service: optometry clinic, ophthalmology clinic, optical dispensing shop, or outpatient eye care center.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the clinician's professional interpretation or service separated from technical fabrication. |
50 | Bilateral procedure |