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HCPCS V2631 · Level II · V code

V2631: Iris supported intraocular lens, HCPCS Level II V code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file.

Key facts for V2631

Medicare payment
$145.73
DMEPOS non-rural state fees
Coverage code
D
special coverage instructions apply
DME supplier MUE
0
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

V2631 is a Level II code from the V section (vision, hearing and speech-language pathology services), in use since 1985: "Iris supported intraocular lens". DMEPOS fees for V2631, a IL (intraocular lenses) item, run $145.73 in every contiguous state (floor $123.87, ceiling $145.73) in the October 2026 file. Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy). No current LCD or billing article lists V2631; its HCPCS coverage code is D (special coverage instructions apply). 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: V2630, V2632, V2628, V2627.

V2631 descriptor and code status

The October 2026 HCPCS Level II file describes V2631 as “Iris supported intraocular lens”. It sits in the V section (vision, hearing and speech-language pathology services), listed with the other V codes.

HCPCS file attributes of V2631
FieldValue
Short descriptorIris support intraoclr lens
Added to HCPCS1985-01-01
Last actionN (no maintenance), effective 2014-10-01
Coverage codeD: special coverage instructions apply
Pricing indicator56: intraocular lenses inserted in a physician's office
BETOS categoryD1F: prosthetic/orthotic devices
Type of serviceQ: vision items or services

Medicare payment for V2631

DMEPOS fees for V2631, a IL (intraocular lenses) item, run $145.73 in every contiguous state (floor $123.87, ceiling $145.73) in the October 2026 file. 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.

DMEPOS fees for V2631 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / 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 V2631

Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy). The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for V2631 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services22 Date of Service Edit: PolicyAnatomic Consideration
Facility outpatient hospital22 Date of Service Edit: PolicyAnatomic Consideration
DME supplier03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for V2631 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists V2631 in v323r0.

V2631 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 V2631 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for V2631

No current LCD or billing and coding article lists V2631. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on V2631

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of V2631 exceed the DME supplier MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for V2631 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for V2631 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS V2631

What does HCPCS code V2631 describe?

"Iris supported intraocular lens" (short descriptor "Iris support intraoclr 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 V2631 a CPT code?

No. V2631 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for V2631?

DMEPOS fees for V2631, a IL (intraocular lenses) item, run $145.73 in every contiguous state (floor $123.87, ceiling $145.73) in the October 2026 file.

How many units of V2631 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy). 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 V2631?

No current LCD or billing article lists V2631; its HCPCS coverage code is D (special coverage instructions apply).

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.

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.