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HCPCS V2790 · Level II · V code

V2790: Amniotic membrane for surgical reconstruction, per procedure, 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); 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); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file 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; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for V2790

Medicare payment
no PFS amount
PFS status X
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
2
practitioner file
LCDs and articles
0 / 1

TL;DR

HCPCS Level II V2790 reads "Amniotic membrane for surgical reconstruction, per procedure" in the October 2026 file; it dates from 2001. The physician fee schedule lists V2790 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction); DME supplier 0 (MAI 3, CMS Policy). In the NCCI PTP files v323r0 V2790 appears in 2 practitioner pairs as column 2 and 0 as column 1 (most often with 65778, 65779). 1 billing and coding article lists V2790 across 7 states: A53441. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS Z2 (not assigned to a BETOS category); pricing indicator 57; type of service Q (vision items or services). Nearby codes: V2785, V2784, V2783, V2782.

V2790 descriptor and code status

The October 2026 HCPCS Level II file describes V2790 as “Amniotic membrane for surgical reconstruction, per procedure”. It sits in the V section (vision, hearing and speech-language pathology services), listed with the other V codes.

HCPCS file attributes of V2790
FieldValue
Short descriptorAmniotic membrane
Added to HCPCS2001-01-01
Last actionN (no maintenance), effective 2003-10-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator57: other contractor-priced
BETOS categoryZ2: not assigned to a BETOS category
Type of serviceQ: vision items or services

Medicare payment for V2790

The physician fee schedule lists V2790 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. 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).

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 V2790

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction); DME supplier 0 (MAI 3, CMS Policy). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for V2790 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
Facility outpatient hospital13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
DME supplier03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for V2790 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, V2790 is the column-2 (bundled) code in 2 active pairs, 0% of which allow a modifier and the column-1 code in 0; 0 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.

Column-1 codes most often paired with V2790 (practitioner)
Column-1 codePairs
65778 (CPT; descriptor licensed by AMA)1
65779 (CPT; descriptor licensed by AMA)1

V2790 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 V2790 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for V2790

0 active Local Coverage Determinations and 1 billing and coding article list V2790. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing V2790
ArticleTitleContractor(s)Related LCD
A53441Billing and Coding: Amniotic Membrane Billing Guidelines for HCPCS Code V2790Palmetto GBA—

Denials to expect on V2790

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists V2790

CARC 151 · N362

units of V2790 exceed the practitioner MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for V2790 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for V2790 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS V2790

What does HCPCS code V2790 describe?

"Amniotic membrane for surgical reconstruction, per procedure" (short descriptor "Amniotic membrane"), in the V section (vision, hearing and speech-language pathology services). Added 2001-01-01; last action N (no maintenance) effective 2003-10-01.

Is V2790 a CPT code?

No. V2790 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "V2790 CPT code" mean this Level II code.

What does Medicare pay for V2790?

The physician fee schedule lists V2790 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it.

How many units of V2790 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction); DME supplier 0 (MAI 3, CMS Policy). For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover V2790?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 billing and coding article lists V2790 across 7 states: A53441.

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.