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    v1.0.28
    OpenPayerBilling CodesVision ServicesHCPCS hcpcs-v2521-contact-lens-toric-prism-ballast
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    HCPCS V2521: Contact Lens, Hydrophilic, Toric or Prism Ballast

    HCPCS Level II code V2521 describes a single hydrophilic contact lens designed with toric or prism ballast features for correction of astigmatism or vertical imbalance; the service is the provision of a specialty contact lens device and is typically associated with durable medical equipment/optical supply or ophthalmology/optometry office settings where lenses are fitted and dispensed.

    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 34-year-old patient with moderate astigmatism presents to an ophthalmology clinic for vision rehabilitation after unsuccessful results with spherical contact lenses. The provider evaluates refractive status, corneal topography, and eyelid anatomy during a comprehensive contact lens fitting visit. A hydrophilic toric contact lens with a prism ballast (V2521, per lens) is selected to correct significant corneal or lenticular astigmatism and to stabilize lens rotation. The clinical workflow includes assessment of visual acuity and refraction, corneal measurements, trial lens fitting, teaching insertion/removal and lens care, and scheduling follow-up for fit evaluation and potential lens replacement. Typical site of service is an outpatient ophthalmology or optometry clinic; lenses may be supplied directly to the patient at the clinic or dispensed through an optical retailer associated with the practice. Patient instructions and documentation include lens parameters, visual acuity with trial lens, tolerance, and any complications such as corneal staining or discomfort.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92004Ophthalmological services: medical examination and evaluation, comprehensive, new patient, one or more visitsPerforms initial comprehensive eye exam and refraction prior to contact lens selection
    92014Ophthalmological services: medical examination and evaluation, established patient, comprehensive, one or more visitsFollow-up comprehensive exam and refraction for established patients before dispensing lenses
    92310Prescription of optical and physical characteristics of and fitting of contact lens, corneal lens, with medical supervision, multiple procedures; corneal lensPerformed during the fitting process for specialty toric contact lenses when corneal lens codes apply; documents fitting and professional services
    92311Follow-up fitting of contact lens, corneal lens; with medical supervisionUsed for follow-up visits to evaluate fit and visual outcome after dispensing toric hydrophilic lens
    92083Visual field examination, extendedMay be performed preoperatively or for special cases where additional assessment is needed prior to specialty lens fitting
    99070Supplies and materials (e.g., diagnostic) provided by the physician over and above those usually included with the office visitUsed when billing for specialized lens care supplies or materials supplied with the lenses

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    152W00000XOptometristDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injurie…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    363LP0808XPsychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    363AS0400XSurgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers · Physician Assistant
    2083X0100XOccupational Medicine PhysicianOccupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environm…
    363LN0005XCritical Care Neonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

    Related ICD-10-CM Codes

    15 rows

    ICD-10-CM CodeDescription
    E10.9Type 1 diabetes mellitus without complications
    G31.84Mild cognitive impairment of uncertain or unknown etiology
    H25.9Unspecified age-related cataract
    H26.9Unspecified cataract
    H40.9Unspecified glaucoma
    H52.4Presbyopia
    H52.6Other disorders of refraction
    H52.7Unspecified disorder of refraction
    H53.9Unspecified visual disturbance
    H57.10Ocular pain, unspecified eye

    Showing 1–10 of 15

    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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