Optometric Procedure Codes
Single Vision
| Procedure Code | Modifier | Description |
|---|---|---|
| V2100 | RT | Sphere, Single Vision, Plano to Plus or Minus 4.00, Per Lens |
| V2100 | LT | Sphere, Single Vision, Plano to Plus or Minus 4.00, Per Lens |
| V2101 | RT | Sphere, Single Vision, Plus or Minus 4.12 to Plus Or Minus 7.00d, Per Lens |
| V2101 | LT | Sphere, Single Vision, Plus or Minus 4.12 to Plus or Minus 7.00d, Per Lens |
| V2102 | RT | Sphere, Single Vision, Plus or Minus 7.12 to Plus or Minus 20.00d, Per Lens |
| V2102 | LT | Sphere, Single Vision, Plus or Minus 7.12 to Plus or Minus 20.00d, Per Lens |
| V2103 | RT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, .12 to 2.00d Cylinder, Per Lens |
| V2103 | LT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, .12 to 2.00d Cylinder, Per Lens |
| V2104 | RT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, 2.12 to 4.00d Cylinder, Per Lens |
| V2104 | LT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, 2.12 to 4.00d Cylinder, Per Lens |
| V2105 | RT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, 4.25 to 6.00d Cylinder, Per Lens |
| V2105 | LT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, 4.25 to 6.00d Cylinder, Per Lens |
| V2106 | RT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, Over 6.00d Cylinder, Per Lens |
| V2106 | LT | Spherocylinder, Single Vision, Plano to Plus or Minus 4.00d Sphere, Over 6.00d Cylinder, Per Lens |
|
V2107 |
RT | Spherocylinder, Single Vision, Plus or Minus 4.25 to Plus or Minus 7.00d Sphere, .12 to 2.00d Cylinder, Per Lens |
| V2107 | LT | Spherocylinder, Single Vision, Plus or Minus 4.25 to Plus or Minus 7.00d Sphere, .12 to 2.00d Cylinder, Per Lens |
| V2108 | RT | Spherocylinder, Single Vision, Plus or Minus 4.25 to Plus or Minus 7.00d Sphere,V2.12 to 4.00d Cylinder, Per Lens |
| V2108 | LT | Spherocylinder, Single Vision, Plus or Minus 4.25 to Plus or Minus 7.00d Sphere,V2.12 to 4.00d Cylinder, Per Len |
| V2109 | RT | Spherocylinder, Single Vision, Plus or Minus 4.25 to Plus or Minus 7.00d Sphere, 4.25 to 6.00d Cylinder, Per Lens |
| V2109 | LT | Spherocylinder, Single Vision, Plus or Minus 4.25 to Plus or Minus 7.00d Sphere, 4.25 to 6.00d Cylinder, Per Lens |
| V2110 | RT | Spherocylinder, Single Vision, Plus or Minus 4.25 to 7.00d Sphere, Over 6.00d Cylinder, Per Lens |
| V2110 | LT | Spherocylinder, Single Vision, Plus or Minus 4.25 to 7.00d Sphere, Over 6.00d Cylinder, Per Lens |
| V2111 | RT | Spherocylinder, Single Vision, Plus or Minus 7.25 to Plus or Minus 12.00d Sphere, .25 to 2.25d Cylinder, Per Lens |
| V2111 | LT | Spherocylinder, Single Vision, Plus or Minus 7.25 to Plus or Minus 12.00d Sphere, .25 to 2.25d Cylinder, Per Lens |
| V2112 | RT | Spherocylinder, Single Vision, Plus or Minus 7.25 to Plus or Minus 12.00d Sphere, 2.25 to 4.00d Cylinder, Per Lens |
| V2112 | LT | Spherocylinder, Single Vision, Plus or Minus 7.25 to Plus or Minus 12.00d Sphere, 2.25 to 4.00d Cylinder, Per Lens |
| V2113 | RT | Spherocylinder, Single Vision, Plus or Minus 7.25to Plus or Minus 12.00d Sphere, 4.25 to 6.00d Cylinder, Per Lens |
| V2113 | LT | Spherocylinder, Single Vision, Plus or Minus 7.25to Plus or Minus 12.00d Sphere, 4.25 to 6.00d Cylinder, Per Lens |
| V2114 | RT | Spherocylinder, Single Vision, Sphere Over Plus or Minus 12.00d, Per Lens |
| V2114 | LT | Spherocylinder, Single Vision, Sphere Over Plus or Minus 12.00d, Per Lens |
| V2115 | RT | Lenticular, (Myodisc), Per Lens, Single Vision |
| V2115 | LT | Lenticular, (Myodisc), Per Lens, Single Vision |
| V2116 | RT | Lenticular Lens, Nonaspheric, Per Lens, Single Vision |
| V2116 | LT | Lenticular Lens, Nonaspheric, Per Lens, Single Vision |
| V2117 | RT | Lenticular, Aspheric, Per Lens, Single Vision |
| V2117 | LT | Lenticular, Aspheric, Per Lens, Single Vision |
| V2118 | RT | Aniseikonic Lens, Single Vision |
| V2118 | LT | Aniseikonic Lens, Single Vision |
| V2199 | RT | Not Otherwise Classified, Single Vision Lens |
| V2199 | LT | Not Otherwise Classified, Single Vision Lens |
| V2410 | RT | Variable Asphericity Lens, Single Vision, Full Field, Glass Or Plastic, Per Lens |
| V2410 | LT | Variable Asphericity Lens, Single Vision, Full Field, Glass Or Plastic, Per Lens |