Key facts for V2630
- Medicare payment
- $145.73
- DMEPOS non-rural state fees
- Coverage code
- D
- special coverage instructions apply
- DME supplier MUE
- 0
- MAI 3
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 0 / 0
TL;DR
CMS describes HCPCS V2630, added in 1985, as "Anterior chamber intraocular lens". The October 2026 DMEPOS fee schedule (category IL, intraocular lenses) sets V2630 at $145.73 in every contiguous state (floor $123.87, ceiling $145.73). CMS caps V2630 at practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. V2630 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1F (prosthetic/orthotic devices); pricing indicator 56; type of service Q (vision items or services). Nearby codes: V2631, V2628, V2632, V2627.
V2630 descriptor and code status
The October 2026 HCPCS Level II file describes V2630 as “Anterior chamber intraocular lens”. It sits in the V section (vision, hearing and speech-language pathology services), listed with the other V codes.
| Field | Value |
|---|---|
| Short descriptor | Anter chamber intraocul lens |
| Added to HCPCS | 1985-01-01 |
| Last action | N (no maintenance), effective 2014-10-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 56: intraocular lenses inserted in a physician's office |
| BETOS category | D1F: prosthetic/orthotic devices |
| Type of service | Q: vision items or services |
Medicare payment for V2630
The October 2026 DMEPOS fee schedule (category IL, intraocular lenses) sets V2630 at $145.73 in every contiguous state (floor $123.87, ceiling $145.73). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.
Physician fee schedule (RVU26D)
Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).
DMEPOS fee schedule (DME26-D)
Jurisdiction L (local Part B MAC), payment category IL (intraocular lenses). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.
| Modifier | Floor / ceiling | Non-rural state range | Rural range | AK / HI / PR / VI |
|---|---|---|---|---|
| none | $123.87 / $145.73 | $145.73 (49 states) | — | AK $145.73, HI $145.73, PR $145.73, VI $145.73 |
Hospital outpatient (OPPS Addendum B)
Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.
Ambulatory surgical center (Addendum BB)
Payment indicator N1 (Packaged service/item; no separate payment made).
Medically Unlikely Edits for V2630
CMS caps V2630 at practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 2 | 2 Date of Service Edit: Policy | Anatomic Consideration |
| Facility outpatient hospital | 2 | 2 Date of Service Edit: Policy | Anatomic Consideration |
| DME supplier | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
The MUE lookup for V2630 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists V2630 in v323r0.
V2630 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.
Pair counts show exposure, not the answer for one claim. Check V2630 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for V2630
No current LCD or billing and coding article lists V2630. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.
Denials to expect on V2630
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for V2630 claims
QuickAuth coordinates the requirement checks and documentation that DME claims for V2630 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.
Frequently asked questions: HCPCS V2630
What does HCPCS code V2630 describe?
"Anterior chamber intraocular lens" (short descriptor "Anter chamber intraocul lens"), in the V section (vision, hearing and speech-language pathology services). Added 1985-01-01; last action N (no maintenance) effective 2014-10-01.
Is V2630 a CPT code?
It is not. V2630 belongs to the V section (vision, hearing and speech-language pathology services) of HCPCS Level II, the CMS code set, not to AMA CPT.
What does Medicare pay for V2630?
The October 2026 DMEPOS fee schedule (category IL, intraocular lenses) sets V2630 at $145.73 in every contiguous state (floor $123.87, ceiling $145.73).
How many units of V2630 can be billed per day?
CMS caps V2630 at practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover V2630?
V2630 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- DMEPOS fee schedule DME26-D, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file DMEPOS_OCT.csvSHA-256 a2824d58aadf4004…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- ASC Addendum BB (covered ancillary services), October 2026Version October 2026 · effective 2026-10-01 · file Oct 2026 ASC BB.txtSHA-256 63cdd7c72aba7a25…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
Disclaimer
This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.