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    v1.0.28
    OpenPayerBilling CodesVision ServicesHCPCS hcpcs-v2207-spherocylinder-bifocal-lens
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    HCPCS Level II V2207: Spherocylinder Bifocal Lens, +4.25 to +7.00 / .12 to 2.00

    HCPCS Level II code V2207 describes a single ophthalmic lens spherocylinder bifocal with spherical power from +4.25 to +7.00 diopters and cylinder from .12 to 2.00 diopters, billed per lens; this code represents a specialty eyewear lens fabrication/service for corrective vision and is typically provided as an optical dispensing service in a retail optical shop or eye care clinic.

    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 68-year-old patient with presbyopia and coexisting regular astigmatism presents to an optometry or ophthalmology clinic for refraction and spectacle dispensing. Following manifest and cycloplegic refraction, the clinician determines the patient requires bifocal spherocylindrical lenses with relatively high spherical power between +4.25 to +7.00 diopters and cylindrical correction between .12 to 2.00 diopters. An optical dispenser or ophthalmic practice orders custom bifocal lenses per lens billed with HCPCS Level II code V2207. Typical workflow: patient assessment and refraction, selection of bifocal segment and materials, lens fabrication order placed with optical lab, receipt and verification of lenses, frame fitting and patient education on bifocal use. Typical site of service is an outpatient eye care clinic, optical dispensary within an ophthalmology/optometry practice, or retail optical shop associated with a medical clinic.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92015Determination of refractive state (refraction), with or without cycloplegiaPerformed prior to ordering prescription spherocylindrical bifocal lenses
    92004Ophthalmological services: new patient, comprehensive, initial; intermediate eye exam (older definition)Performed when comprehensive eye exam is required to diagnose refractive needs (modern equivalents vary by payer)
    99213Office or other outpatient visit for evaluation and management, established patient, low to moderate complexityTypical visit level for follow-up and prescription verification before dispensing lenses
    92340Spectacle lens, single vision, plastic, prescription, per lensRelated as an alternative lens type; used when single-vision rather than bifocal lenses are supplied
    92342Spectacle lens, bifocal, plastic, prescription, per lensCommonly used for billing bifocal spectacle lenses when payer requires CPT-level reporting

    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…
    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…
    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…
    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
    174400000XSpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
    207W00000XOphthalmology PhysicianAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
    261QP2300XPrimary Care Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    363LA2200XAdult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    225XR0403XDriving and Community Mobility Occupational TherapistOccupational therapists can optimize and prolong an older driver's ability to drive safely and ease the transition to other forms of transportation if…
    171000000XMilitary Health Care ProviderActive duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative …
    1744R1103XResearch Study Abstracter/CoderOther Service Providers · Specialist
    207QG0300XGeriatric Medicine (Family Medicine) PhysicianA family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitati…

    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-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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