Optometric Procedure Codes
Prosthetic Eye
| Procedure Code | Modifier | Description |
|---|---|---|
| V2620 | RT | Prosthetic, Eye, Glass, Stock |
| V2620 | LT | Prosthetic, Eye, Glass, Stock |
| V2621 | RT | Prosthetic, Eye, Plastic, Stock |
| V2621 | LT | Prosthetic, Eye, Plastic, Stock |
| V2622 | RT | Prosthetic, Eye, Glass, Custom |
| V2622 | LT | Prosthetic, Eye, Glass, Custom |
| V2623 | RT | Prosthetic, Eye, Plastic, Custom |
| V2623 | LT | Prosthetic, Eye, Plastic, Custom |
| V2629 * | RT | Prosthetic, Eye, Other Type |
| V2629 * | LT | Prosthetic, Eye, Other Type |
Other Lens
| Procedure Code | Modifier | Description |
|---|---|---|
| V2630 * | RT | Anterior Chamber Intraocular Lens |
| V2630 * | LT | Anterior Chamber Intraocular Lens |
| V2632 * | RT | Posterior Chamber Intraocular Lens |
| V2632 * | LT | Posterior Chamber Intraocular Lens |
| V2700 | RT | Balance Lens, Per Lens |
| V2700 | LT | Balance Lens, Per Lens |
| V2710 | RT | Slab Off Prism, Glass Or Plastic, Per Lens |
| V2710 | LT | Slab Off Prism, Glass Or Plastic, Per Lens |
| V2715 | RT | Prism, Per Lens |
| V2715 | LT | Prism, Per Lens |
| V2718 | RT | Press-On Lens, Fresnell Prism, Per Lens |
| V2718 | LT | Press-On Lens, Fresnell Prism, Per Lens |
| V2730 | RT | Special Base Curve, Glass Or Plastic, Per Lens |
| V2730 | LT | Special Base Curve, Glass Or Plastic, Per Lens |
| V2499 | RT | Variable Sphericity Lens, Other Type |
| V2499 | LT | Variable Sphericity Lens, Other Type |
| V2755 | RT | U-V Lens, Per Lens |
| V2755 | LT | U-V Lens, Per Lens |
| V2780 | RT | Oversize Lens, Per Lens |
| V2780 | LT | Oversize Lens, Per Lens |
Tints
| Procedure Code | Modifier | Description |
|---|---|---|
| V2744 | RT | Tint, Photochromatic, Per Lens |
| V2744 | LT | Tint, Photochromatic, Per Lens |
Miscellaneous Codes
| Procedure Code | Modifier | Description |
|---|---|---|
| V2799 | Vision Service, Miscellaneous |
* Prior Authorization Required for this Procedure