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V2105 - Spherocylinder 4.00d/4.25-6d

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Field Value
HCPCS Code: V2105
Long Description: Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens
Short Description: Spherocylinder 4.00d/4.25-6d
Pricing Indicator 1: 38 (Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
Statute Number:
Coverage Code: C (Carrier judgment)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: D1F (Orthotic devices)
Type of Service Code 1: Q (Vision items or services)
Anesthesia Base Unit Quality: 0
Code Added: 01-01-1985
Action Effective Date: 01-10-2003
Action Code: N (No maintenance for this code)