Vision codes V2020 to V2784 with Medicaid rates by state

101 vision codes from V2020 to V2784 carry a published Medicaid rate in ten or more states. The median shown is across those states' unmodified published rates; open a code for the full state-by-state table with percent of Medicare and prior-authorization flags.

CodeDescriptionStatesMedian rate
V2020Frames, purchases35$41.12
V2025Deluxe frame16$47.50
V2100Sphere, single vision, plano to plus or minus 4.00, per lens35$18.90
V2101Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens35$20.53
V2102Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens35$33.98
V2103Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens35$18.02
V2104Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens35$18.28
V2105Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens35$22.53
V2106Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens35$30.15
V2107Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens33$21.21
V2108Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens34$22.18
V2109Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens34$24.66
V2110Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens34$28.18
V2111Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens34$25.74
V2112Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens34$26.50
V2113Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens34$29.33
V2114Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens33$44.69
V2115Lenticular, (myodisc), per lens, single vision33$51.36
V2118Aniseikonic lens, single vision26$71.12
V2121Lenticular lens, per lens, single31$50.84
V2200Sphere, bifocal, plano to plus or minus 4.00d, per lens35$33.00
V2201Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens35$37.90
V2202Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens34$42.60
V2203Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens35$34.13
V2204Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens35$35.65
V2205Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens34$39.67
V2206Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens34$42.13
V2207Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens34$36.41
V2208Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens34$38.48
V2209Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens34$41.75
V2210Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens34$45.14
V2211Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens34$41.42
V2212Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens34$42.60
V2213Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens34$46.31
V2214Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens33$49.28
V2215Lenticular (myodisc), per lens, bifocal31$72.35
V2218Aniseikonic, per lens, bifocal26$98.66
V2219Bifocal seg width over 28 mm31$37.92
V2220Bifocal add over 3.25d32$27.90
V2221Lenticular lens, per lens, bifocal33$57.95
V2300Sphere, trifocal, plano to plus or minus 4.00d, per lens30$42.35
V2301Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens30$46.42
V2302Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens29$55.19
V2303Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens30$42.59
V2304Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens29$56.00
V2305Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens29$56.00
V2306Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens29$55.36
V2307Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens29$56.00
V2308Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens29$56.00
V2309Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens29$58.46
V2310Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens28$57.23
V2311Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens28$55.17
V2312Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens28$55.30
V2313Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens29$57.53
V2314Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens28$63.20
V2315Lenticular, (myodisc), per lens, trifocal24$103.80
V2318Aniseikonic lens, trifocal22$140.84
V2319Trifocal seg width over 28 mm25$46.49
V2320Trifocal add over 3.25d28$32.12
V2321Lenticular lens, per lens, trifocal26$75.98
V2410Variable asphericity lens, single vision, full field, glass or plastic, per lens28$74.27
V2430Variable asphericity lens, bifocal, full field, glass or plastic, per lens29$97.71
V2500Contact lens, pmma, spherical, per lens27$82.34
V2501Contact lens, pmma, toric or prism ballast, per lens25$141.00
V2502Contact lens, pmma, bifocal, per lens21$172.35
V2503Contact lens, pmma, color vision deficiency, per lens17$158.51
V2510Contact lens, gas permeable, spherical, per lens28$108.04
V2511Contact lens, gas permeable, toric, prism ballast, per lens26$167.37
V2512Contact lens, gas permeable, bifocal, per lens22$207.25
V2513Contact lens, gas permeable, extended wear, per lens22$154.02
V2520Contact lens, hydrophilic, spherical, per lens28$106.40
V2521Contact lens, hydrophilic, toric, or prism ballast, per lens26$174.07
V2522Contact lens, hydrophilic, bifocal, per lens22$187.05
V2523Contact lens, hydrophilic, extended wear, per lens23$149.15
V2530Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)21$193.81
V2531Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)23$506.52
V2623Prosthetic eye, plastic, custom40$934.09
V2624Polishing/resurfacing of ocular prosthesis40$55.15
V2625Enlargement of ocular prosthesis39$368.59
V2626Reduction of ocular prosthesis38$210.88
V2627Scleral cover shell38$1,320.43
V2628Fabrication and fitting of ocular conformer38$298.21
V2630Anterior chamber intraocular lens19$140.63
V2631Iris supported intraocular lens12$124.03
V2632Posterior chamber intraocular lens19$142.87
V2700Balance lens, per lens27$42.06
V2710Slab off prism, glass or plastic, per lens30$58.06
V2715Prism, per lens32$10.44
V2718Press-on lens, fresnell prism, per lens26$27.05
V2730Special base curve, glass or plastic, per lens24$18.07
V2744Tint, photochromatic, per lens25$15.78
V2745Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens22$8.42
V2750Anti-reflective coating, per lens13$20.63
V2755U-v lens, per lens24$13.10
V2760Scratch resistant coating, per lens17$14.39
V2770Occluder lens, per lens21$19.83
V2780Oversize lens, per lens18$10.98
V2781Progressive lens, per lens10$35.00
V2782Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens15$61.90
V2783Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens17$69.77
V2784Lens, polycarbonate or equal, any index, per lens26$32.00

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.