HCPCS V2626 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Vision Services • Eye Prosthetics and Services |
| Complexity Level | Moderate |
National average reimbursement for HCPCS V2626 by major payers:
$260.53
$146.41
$221.38
$197.48
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS V2626 | ||||||
United | V2626 | $113.68 | 1174639694 - M. QUIRANTES ORTHOPEDIC APPLIANCES, INC. | 591886175 - (FL) M QUIRANTES ORTHOPEDIC APPLIANCES INC | FL | Prosthetic/Orthotic Supplier (335E00000X) |
United | V2626 | $149.80 | 1306923149 - ORTHOPAEDIC SURGERY ASSOCIATES, PA | 650640914 - (FL) ORTHOPAEDIC SURGERY ASSOCIATES PA | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $139.38 | 1144692013 - BREVARD PROSTHETICS & ORTHOTICS, INC, CARDINAL P & O | 593421786 - (FL) BREVARD PROSTHETICS ORTHOTICS INC | FL | Prosthetic/Orthotic Supplier (335E00000X) |
United | V2626 | $80.98 | 1003894247 - PULMONICS INC | 592416954 - (FL) PULMONICS INC | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $116.86 | 1265638977 - ORTHOSTAT, CORP. | 260302728 - (FL) ORTHOSTAT CORP | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $92.05 | 1255380168 - CAPITAL MEDICAL AND SURGICAL INC. | 20681162 - (FL) CAPITAL MEDICAL AND SURGICAL INC | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $80.98 | 1831126275 - FLORIDA BRACE & LIMB, INC. | 593330956 - FLORIDA BRACE LIMB INC | FL | Prosthetist (224P00000X) |
United | V2626 | $135.25 | 1952597205 - CORDANO EYE CARE CENTER PA | 593603343 - (FL) CORDANO EYE CARE CENTER PA | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $113.68 | 1649274556 - MOBILE PROSTHETICS & ORTHOTICS, INC., PROSTHETIC & ORTHOTIC ASSOCIATES | 593232766 - (FL) MOBILE PROSTHETICS ORTHOTICS INC | FL | Prosthetic/Orthotic Supplier (335E00000X) |
United | V2626 | $161.05 | 1134173529 - QUANTUM MEDICAL SUPPLY, INC. | 582672225 - (FL) QUANTUM MEDICAL SUPPLY INC | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $107.87 | 1487794848 - BARR PROSTHETICS & ORTHOTICS, PA, CLEARWATER PROSTHETICS & ORTHOTICS | 710932032 - (FL) BARR PROSTHETICS ORTHOTICS PA | FL | Prosthetic/Orthotic Supplier (335E00000X) |
United | V2626 | $139.38 | 1497120935 - ORTHOTIC & PROSTHETIC CENTERS, INC., ORTHOTIC & PROSTHETIC CENTER OF CAPE CORAL | 592139250 - ORTHOTIC PROSTHETIC CENTERS INC | FL | Prosthetic/Orthotic Supplier (335E00000X) |
United | V2626 | $107.98 | 1639114788 - SOUTHWEST MOBILITY INC., SCOOTER MOBILITY CENTER | 593436933 | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $179.77 | 1609858752 - CUSTOM MOBILITY INC | 592924116 - (FL) CUSTOM MOBILITY INC | FL | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | V2626 | $80.90 | 1871747386 - M & M REHAB., INC., MID-FLORIDA PROSTHETICS & ORTHOTICS | 593575573 - (FL) M M REHAB INC | FL | Prosthetic/Orthotic Supplier (335E00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS V2626 vs. Other Eye Prosthetics and Services Codes
The HCPCS V2626 code is part of the Vision Services services used for Eye Prosthetics and Services. 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 V2626 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.
| Code | Complexity | Description |
|---|---|---|
| V2625-HCPCS | Moderate | Enlargement of ocular prosthesis |
| V2626-HCPCS | Moderate | Reduction of ocular prosthesis |
| V2627-HCPCS | High | Scleral cover shell |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V2626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the V2626 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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