HCPCS Level IIvisionActive
V2104
Spherocylindr 4.00d/2.12-4d
BETOS: D1F
Effective: 2003-10-01
Referenced in 3 policies
Description
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens
Medicare Fee Schedule
2026 Medicare Physician Fee Schedule national payment rates
Statutory Exclusion
This code has a statutory exclusion from Medicare coverage.
Coverage Policies