V2623 — Prosthetic eye, plastic, custom
V2623 is a HCPCS Level II code for prosthetic eye, plastic, custom. It belongs to the Vision, Hearing and Speech-Language Pathology section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of V2623 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
- DME supplier
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for V2623
- Long descriptor
- Prosthetic eye, plastic, custom
- Short descriptor
- Plastic eye prosth custom
- Added
- January 1, 1985
- BETOS
- D1F
- Pricing indicator
- 38 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to V2623
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If V2623 is not quite right, the correct code is very often within a few positions of it.
- V2525Contact lens, hydrophilic, dual focus, per lens
- V2526Contact lens, hydrophilic, with blue-violet filter, per lens
- V2530Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)
- V2531Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)
- V2599Contact lens, other type
- V2600Hand held low vision aids and other nonspectacle mounted aids
- V2610Single lens spectacle mounted low vision aids
- V2615Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound microscopic lens system
- V2624Polishing/resurfacing of ocular prosthesis
- V2625Enlargement of ocular prosthesis
- V2626Reduction of ocular prosthesis
- V2627Scleral cover shell
- V2628Fabrication and fitting of ocular conformer
- V2629Prosthetic eye, other type
- V2630Anterior chamber intraocular lens
- V2631Iris supported intraocular lens
Questions about V2623
What is HCPCS code V2623?
V2623 is a HCPCS Level II code for prosthetic eye, plastic, custom. It sits in the Vision, Hearing and Speech-Language Pathology section.
Does Medicare cover V2623?
The CMS HCPCS file marks V2623 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is V2623 paid under the physician fee schedule?
V2623 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.