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HCPCS V2511 Fee Schedule

Last Verified: September 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Contact lens, gas permeable, toric, prism ballast, per lens
Key FactDetail
Service Type

Vision Services

Assorted Contact Lenses

Common Place of Service
Common Modifiers
Complexity LevelModerate

National average reimbursement for HCPCS V2511 by major payers:

bcbs

$195.48

uhc

$119.82

aetna

$166.00

cigna

$271.91

Preview provider-level rates for...
For billing codeHCPCS V2511
PayerCodeRateNPITax IDStateSpecialty

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HCPCS V2511 vs. Other Assorted Contact Lenses Codes

The HCPCS V2511 code is part of the Vision Services services used for Assorted Contact Lenses. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS V2511 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
V2510LowContact lens, gas permeable, spherical, per lens
V2511LowContact lens, gas permeable, toric, prism ballast, per lens
V2512ModerateContact lens, gas permeable, bifocal, per lens

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V2511. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the V2511 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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Medicare Reimbursement Lookup Tool

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YearBilling CodeLocalityNon-Facility FeeFacility Fee