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HCPCS V2628 Fee Schedule

Last Verified: September 2026

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.

Fabrication and fitting of ocular conformer
Key FactDetail
Service Type

Vision Services

Eye Prosthetics and Services

Complexity LevelModerate
Medicaid Fee ScheduleView Medicaid rates for V2628

National average reimbursement for HCPCS V2628 by major payers:

bcbs

$374.86

uhc

$214.47

aetna

$311.83

cigna

$299.98

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS V2628.

HCPCS V2628
5 of 25 sample ratesHigher to lower in this preview
  1. Lincare Inc.

    FLOxygen Equipment & Supplies (DME)NPI 1336471424Tax ID 59-2852900

    $273.50Published rate
  2. Jay Ananthan-Nair, Od, PA, Debary Optical/Schmidt Optical

    Jay Ananthannair Od PA

    FLCustomized Equipment (DME)NPI 1932174018Tax ID 59-3540140

    $192.00Published rate
  3. Amputee Clinic, Inc.

    Amputee Clinic Inc

    FLProsthetic/Orthotic SupplierNPI 1295730216Tax ID 45-4672954

    $173.36Published rate
  4. M. Davis Management, Inc., Proximed

    M. Davis Management, Inc.

    FLOxygen Equipment & Supplies (DME)NPI 1689603300Tax ID 59-3143582

    $150.78Published rate
  5. Gulf Coast Orthotics & Prosthetics Center, LLC

    FLProsthetic/Orthotic SupplierNPI 1538355250Tax ID 26-0868757

    $114.51Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS V2628 vs. Other Eye Prosthetics and Services Codes

The HCPCS V2628 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 V2628 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
V2627-HCPCSHighScleral cover shell
V2628-HCPCSModerateFabrication and fitting of ocular conformer
V2629-HCPCSModerateProsthetic eye, other type

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V2628. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the V2628 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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