V2628 — Fabrication and fitting of ocular conformer
V2628 is a HCPCS Level II code for fabrication and fitting of ocular conformer. It belongs to the Vision, Hearing and Speech-Language Pathology section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
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 V2628 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 3 — Date of Service Edit: Clinical · Nature of Service/Procedure
- DME supplier
- 2 units MAI 3 — Date of Service Edit: Clinical · Nature of Service/Procedure
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 V2628
- Long descriptor
- Fabrication and fitting of ocular conformer
- Short descriptor
- Fabrication & fitting
- Added
- January 1, 1993
- 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 V2628
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If V2628 is not quite right, the correct code is very often within a few positions of it.
- 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
- V2623Prosthetic eye, plastic, custom
- V2624Polishing/resurfacing of ocular prosthesis
- V2625Enlargement of ocular prosthesis
- V2626Reduction of ocular prosthesis
- V2627Scleral cover shell
- V2629Prosthetic eye, other type
- V2630Anterior chamber intraocular lens
- V2631Iris supported intraocular lens
- V2632Posterior chamber intraocular lens
- V2700Balance lens, per lens
- V2702Deluxe lens feature
- V2710Slab off prism, glass or plastic, per lens
- V2715Prism, per lens
Questions about V2628
What is HCPCS code V2628?
V2628 is a HCPCS Level II code for fabrication and fitting of ocular conformer. It sits in the Vision, Hearing and Speech-Language Pathology section.
Does Medicare cover V2628?
The CMS HCPCS file marks V2628 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is V2628 paid under the physician fee schedule?
V2628 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.