HCPCS V2110: Spherocylinder Single-Vision Lens, High Power

HCPCS Level II code V2110 identifies a single-vision spherocylinder corrective lens with spherical power of +/- 4.25 to 7.00 diopters and an astigmatic cylinder exceeding 6.00 diopters, billed per lens. This code is relevant for vision benefits, optical suppliers, and clinicians managing high-refractive-error prescriptions that require specialized lens fabrication. Nationally, V2110 matters because lenses with these specifications can incur higher material and manufacturing costs and may be subject to specific coverage rules across payers.

Key payers included in the coverage analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, expected sites of service, and typical clinical context for use. The publication provides benchmarks where available, notes on payer coverage patterns, and policy considerations that affect billing and claims adjudication for high-power single-vision spherocylinder lenses.

This summary equips optical suppliers, billing staff, and clinicians with a clear national-level explanation of the code, common payment considerations, and areas to review in payer policies when submitting claims for high-power single-vision lenses.

Billing Code Overview

HCPCS Level II code V2110 describes a spherocylinder single-vision lens where the spherical power is +/- 4.25 to 7.00 diopters with an astigmatic cylinder greater than 6.00 diopters, billed per lens. This code applies to the manufacture or supply of corrective ophthalmic lenses with relatively high sphere and cylinder powers.

Service type: Corrective ophthalmic lens (single-vision spherocylinder), per lens

Typical site of service: Optical dispensary, ophthalmology or optometry clinic, retail optical store, or outpatient vision care setting

Clinical Context

A 54-year-old patient presents to an optometry or ophthalmology clinic with progressively worsening blurred vision and difficulty with near and distance tasks. Manifest refraction reveals a high astigmatic component greater than 6.00 diopters and a spherical power between +4.25 and +7.00 diopters in one or both eyes. The clinician documents a physician- or optometrist-performed refraction and prescribes single-vision spherocylindrical spectacle lenses to correct the refractive error. The optical laboratory receives the prescription and fabricates a single-vision lens with the specified sphere and cylinder powers; billing for the lens material and fabrication is submitted using the HCPCS Level II code V2110 (spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens).

Typical workflow steps:

Patient presents for refractive assessment and ocular exam.
Refraction and biomicroscopy performed by optometrist or ophthalmologist; refraction documented in the medical record.
Lens prescription is written specifying sphere and cylinder powers that meet the V2110 parameters.
Optical dispenser or external laboratory fabricates the lens; invoice or claim for lens material uses V2110 per lens.
Claims may include appropriate modifiers to indicate laterality, service or rendering provider specifics, or unusual circumstances during fabrication or delivery.

Typical site of service: outpatient eye care facilities, optometry clinics, ophthalmology offices, retail optical dispensaries, and independent optical laboratories where spectacle lenses are fabricated and billed.

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral procedure	Use when billing for both left and right lenses on a single claim line when permitted by payer policy.
`52`	Reduced services	Use if the lens is partially completed or service performed is less than described by `V2110`.
`53`	Discontinued procedure	Use if fabrication was started but discontinued for reasons outside the provider's control.
`54`	Surgical care only	Rare for this supply code; use only if relevant to surgical supply billing per payer rules.
`55`	Postoperative management only	Rarely applicable; use per payer instructions when lens relates to postoperative refractive management.
`62`	Two surgeons	Use when two providers share responsibility in a way that affects billing per payer guidance.
`78`	Return to operating room	Not typical; include only if applicable under exceptional circumstances defined by payer.
`80`	Assistant surgeon	Use when an assistant surgeon is involved and payer allows modifier for supply-related claims.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist billing	Use when an eligible non-physician practitioner furnishes the service within their scope and payer allows.
`NU`	New equipment	Use when the lens is a newly introduced item requiring NU modifier per supplier billing rules.
`QK`	Medical direction of two, three, or four assistants	Apply when the billing relates to services involving specific supervisory arrangements impacting the claim.
`QX`	Certified registered nurse anesthetist service with medical direction by physician	Not typical for lens billing; include only if payer instructs for complex service bundles.
`QY`	Medical direction of one CRNA by an anesthesiologist	As above, rarely applicable to optical supply claims.
`UE`	Services provided in whole or part by an employed physician	Use when applicable to indicate employer-employee relationship for the rendering provider.

Taxonomy Code	Specialty	Notes
`261QP2400X`	Ophthalmology	Comprehensive and refractive care; prescribes and manages spectacle correction.
`174400000X`	Optometry	Performs refraction and prescribes spectacle lenses; often dispenses or coordinates fabrication.
`3336C0002X`	Optical/Dispensing	Licensed optical dispenser or optician responsible for lens fabrication and fitting.
`176B00000X`	Ophthalmic Plastic and Reconstructive Surgery	Occasionally involved when ocular adnexal or prosthetic considerations affect lens choice.
`207L00000X`	Ophthalmic Pathology	Rarely involved; included when specialty consultation impacts eyewear specifications.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H52.12`	Myopia, bilateral	Common refractive error that may require high-power single-vision spherocylindrical lenses when combined with significant astigmatism.
`H52.13`	Hypermetropia, bilateral	Hyperopia within the spherical range of `V2110` may necessitate high-plus lenses with significant cylinder correction.
`H52.4`	Presbyopia	May coexist with refractive errors; single-vision lenses could be prescribed for specific visual needs.
`H52.2`	Astigmatism	Primary diagnosis for which a spherocylindrical lens with cylinder over 6.00D is indicated.
`H52.8`	Other disorders of refraction	Includes complex refractive presentations requiring nonstandard lens powers like those described by `V2110`.
`H54.7`	Unspecified visual loss	May motivate detailed refractive correction attempts when visual impairment is due to uncorrected refractive error.
`Z01.00`	Encounter for examination of eyes and vision without abnormal findings	Encounters where refraction is performed and a prescription matching `V2110` parameters is issued.
`Z79.899`	Other long term (current) drug therapy	Included when concurrent long-term ocular medications influence refractive management and lens selection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`92015`	Determination of refractive state (refraction), with or without cycloplegia; includes measurement of refractive error and prescription	Performed before prescribing the single-vision spherocylinder lens; documents need for `V2110`.
`92002`	Ophthalmological services: medical examination and evaluation, new patient; intermediate, with initiation of diagnostic and treatment program (no refraction)	Initial comprehensive ophthalmologic evaluation that may identify refractive issues leading to lens prescription.
`92004`	Ophthalmological services: comprehensive, new patient, with initiation of diagnostic and treatment program	Comprehensive eye exam that includes evaluation necessary to prescribe corrective lenses.
`92340`	Prescription of optical and physical characteristics of and fit of contact lens for aphakia, per lens	Related optical supply code for contact lens workup when contact lenses are considered instead of spectacles.
`92342`	Fitting and dispensing of spectacles; complete, per pair	Clinical service code for spectacle fitting and dispensing that pairs with lens fabrication billed by `V2110`.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	Used when additional non-standard materials or special fabrication processes for lenses are billed alongside `V2110`.

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Summary & Overview