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    v1.0.28
    OpenPayerBilling CodesVision ServicesHCPCS hcpcs-v2784-polycarbonate-lens-per-lens
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    HCPCS Level II V2784: Polycarbonate Lens, Per Lens

    HCPCS Level II code V2784 represents a single polycarbonate lens supplied for eyeglass prescriptions, described as “Lens, polycarbonate or equal, any index, per lens.” The service is the provision of an optical lens (healthcare durable medical supply) typically provided in optical/vision clinics, ophthalmology or optometry offices, and outpatient durable medical equipment settings for corrective eyewear needs.

    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 12-year-old patient presents to an ophthalmology clinic with an order for corrective eyeglass lenses made of polycarbonate due to high risk for impact-related ocular injury and pediatric wear. The optometrist documents refraction and verifies the spectacle prescription. The optical dispenser receives an order for V2784 (Lens, polycarbonate or equal, any index, per lens) to fabricate the lenses. Typical workflow: refraction and frame selection at the clinic; prescription transmitted to optical laboratory; lenses fabricated or ordered with required coatings and given to patient at dispensing visit. Typical site of service is an outpatient ophthalmology or optometry clinic, optical shop, or contracted lens laboratory. Common clinical scenarios include pediatric prescriptions, patients with a history of contact sports or occupational exposure, and patients with a documented need for shatter-resistant lenses due to safety concerns.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92015Determination of refractive state (refraction)Performed before ordering spectacle lenses to determine the prescription
    92004Comprehensive ophthalmological service, new patient, one or more visits (medical eye exam)May precede spectacle prescription when medical eye disease is evaluated
    92014Comprehensive ophthalmological service, established patientMay precede or accompany refraction and lens ordering
    92340Ophthalmic optics; fitting of spectacle lenses (separate procedure)Directly related to dispensing and fitting of lenses
    99173Vision screening by automated instrumentScreening performed in some clinics prior to referral for full refraction

    Related Modifiers

    5 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…
    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…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    P1Modifier P1 indicates an ASA Physical Status I — a normal healthy patient — and is appended to anesthesia CPT codes (00100–01999) based on the anesthesiologist’s clinical assessment. It documents the…- When to apply: Use modifier P1 on anesthesia CPT codes (00100–01999) when the anesthesia provider assigns ASA Physical Status I — a normal healthy patient (non‑smoker, minimal or no alcohol use).…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RI0011XInterventional Cardiology PhysicianAn area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and p…
    101YS0200XSchool CounselorBehavioral Health & Social Service Providers · Counselor
    261QM1200XMagnetic Resonance Imaging (MRI) Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    175F00000XNaturopathDiagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural…
    364SH1100XHolistic Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    364SC1501XCommunity Health/Public Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    207SG0207XMedical Biochemical GeneticsA medical biochemical geneticist specializes in the diagnosis, evaluation, prevention, and treatment of patients with biochemical genetic disorders, d…
    237600000XAudiologist-Hearing Aid FitterAn audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of …

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    H04.423Chronic lacrimal canaliculitis of bilateral lacrimal passages
    H10.9Unspecified conjunctivitis
    H16.9Unspecified keratitis
    H52.4Presbyopia
    H52.6Other disorders of refraction
    H52.7Unspecified disorder of refraction
    H53.11Day blindness
    H53.121Transient visual loss, right eye
    H53.122Transient visual loss, left eye
    H53.2Diplopia

    Showing 1–10 of 24

    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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