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    v1.0.28
    OpenPayerBilling CodesVision ServicesHCPCS hcpcs-v2204-spherocylinder-bifocal-lens-plano-to-4d
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    HCPCS Level II V2204: Spherocylinder Bifocal Lens, Per Lens

    HCPCS Level II code V2204 describes a single spherocylinder bifocal ophthalmic lens specified as plano to ±4.00 diopter sphere with 2.12 to 4.00 diopter cylinder, billed per lens for corrective eyeglass fabrication; the service is an optical lens supply typically provided in an optical shop or outpatient eyewear dispensing setting for patients requiring combined spherical and cylindrical correction with a bifocal add.

    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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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient presents to an optometry or ophthalmology clinic with progressive presbyopia and distance visual acuity corrected with astigmatic refractive error. The clinician documents a manifest refraction that includes spherical correction within the plano to ±4.00 diopter range and a cylindrical component between 2.12 and 4.00 diopters. The patient requests spectacle correction for both distance and near and the provider prescribes a bifocal, spherocylindrical lens to address both spherical and significant astigmatic refractive error.

    The typical clinical workflow includes: initial visual acuity testing, autorefractor/keratometry measurements, manifest refraction, binocular vision assessment for bifocal fitting, lens order entry with lens parameters (spherical, cylindrical, axis, bifocal segment), verification of patient identification and insurance, and remittance of the ordered lens to an optical lab. The ordering provider is commonly an optometrist or ophthalmologist; optical dispensing staff or a licensed optician complete measurements for frame fit and finalize the order. Lens fabrication and dispensing occur in an optical workshop or contracted laboratory; follow-up includes fit verification and any necessary adjustments.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92015Determination of refractive state (refraction) with or without autorefractionPerformed prior to lens ordering to document the prescription used to order the spherocylinder bifocal lens
    92004Comprehensive ophthalmological services, new patient; intermediate, with initiation of diagnostic and treatment program (dilation, etc.)May be part of the exam when ocular disease must be assessed before prescribing specialized lenses
    92014Comprehensive ophthalmological services, established patientOffice exam for established patients where refraction and lens prescription are updated
    92340Prescription of optical materials for single lens, spectacle (per lens)Related optical supply coding; used for billing lenses and materials in some payor scenarios
    99070Supplies and materials provided by the physician over and above those usually included with the office visitUsed if additional nonstandard materials or custom lens processing charges are billed alongside the lens order

    Related Modifiers

    6 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…
    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…
    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…
    175L00000XHomeopathA provider who is educated and trained in a system of therapeutics in which diseases are treated by drugs which are capable of producing in healthy pe…
    2278G1100XGeneral Care Certified Respiratory TherapistThis level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as…
    332BX2000XOxygen Equipment & Supplies (DME)Suppliers · Durable Medical Equipment & Medical Supplies
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    246XC2903XVascular Specialist/Technologist CardiovascularA vascular technologist, also known as a vascular sonographer, creates images of blood vessels and collects data that help physicians diagnose disorde…
    2471Q0001XQuality Management Radiologic TechnologistA radiologic technologist who specializes in quality management.
    163WG0100XGastroenterology Registered NurseNursing Service Providers · Registered Nurse

    Related ICD-10-CM Codes

    17 rows

    ICD-10-CM CodeDescription
    H25.11Age-related nuclear cataract, right eye
    H26.9Unspecified cataract
    H46.9Unspecified optic neuritis
    H47.619Cortical blindness, unspecified side of brain
    H52.13Myopia, bilateral
    H52.4Presbyopia
    H53.8Other visual disturbances
    H53.9Unspecified visual disturbance
    H54.8Legal blindness, as defined in USA
    H57.10Ocular pain, unspecified eye

    Showing 1–10 of 17

    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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