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    v1.0.28
    OpenPayerBilling CodesVision ServicesHCPCS hcpcs-v2201-bifocal-spherical-lens-plus-minus-4-12-to-7-00
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    HCPCS Level II V2201: Bifocal Spherical Lens +/-4.12 to +/-7.00 per Lens

    HCPCS Level II code V2201 describes a single eyeglass lens that is a bifocal spherical lens with a power range of +/- 4.12 to +/- 7.00 diopters, intended for refractive correction; the service is for provision of a manufactured ophthalmic lens and is typically delivered in an optical dispensary or ophthalmology/optometry clinic when lenses are ordered or supplied to a patient.

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

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    Clinical & Coding Specifications

    Clinical Context

    A patient presents to an optometry or ophthalmology clinic requesting bifocal eyeglasses due to decreasing near vision while maintaining distance vision. The provider performs a comprehensive eye exam including refraction, slit-lamp exam, and binocular vision assessment. Objective and subjective refraction determine spherical power within the range of ±4.12 to ±7.00 diopters with a bifocal segment required for near tasks. The clinic documents the prescription, optical parameters (sphere, cylinder if applicable, axis, add power, and bifocal type), and provides or orders lenses labeled as V2201 per lens. Typical workflow includes verification of patient identity and insurance, measurement for frame-fit and pupillary distance, entry of the V2201 lens order into the optical lab system, application of standard lens fabrication modifiers as appropriate, delivery appointment with fitting and patient education, and documentation of the final dispensed item in the medical record.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92015Determination of refractive state (refraction)Performed before prescribing bifocal lenses to establish accurate spherical power within the V2201 range.
    92004Ophthalmological services: comprehensive exam, new patient, one or more visitsMay precede lens prescription when a comprehensive medical eye exam is required.
    92014Comprehensive eye exam for established patientUsed for routine follow-up visits where lens changes like V2201 are prescribed.
    99173Screening test of visual acuity, quantitative, bilateralAncillary vision screening performed in some clinics prior to full refraction.
    99070Supplies and materials (non-durable)Used by clinic to bill for non-standard expendable supplies associated with lens fitting when allowed by payor.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…

    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…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207YX0901XOtology & Neurotology PhysicianAn otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology a…
    103TF0200XForensic PsychologistA psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial a…
    207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianA family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesse…
    2471S1302XSonography Radiologic TechnologistA radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…
    253Z00000XIn Home Supportive Care AgencyAn In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provi…
    163WX0200XOncology Registered NurseNursing Service Providers · Registered Nurse

    Related Payer Policy Updates

    Specialty: Ophthalmology/Optometry1 / 2

    4 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

    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-V2100-SINGLE-VISION-SPHERE-LENS-PLANO-TO-PLUS-MINUS-4

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

    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

    Showing 1–10 of 123

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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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