HCPCS Service Codes - Vision items or services

HCPCS Service Code Q for Vision items or services.

HCPCS Type of Service (TOS) code is an indicator that the contractor places on Form CMS-1500. The indicator is mainly used for data purposes, however in some instances, it affects payment. All HCPCS codes have a corresponding TOS indicator.

Below are all available HCPCS TOS codes. Find an HCPCS code based on the type of service.

HCPCS Codes for Vision items or services

  • G0117

    Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist

  • G0118

    Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist

  • J7311

    Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg

  • S0500

    Disposable contact lens, per lens

  • S0504

    Single vision prescription lens (safety, athletic, or sunglass), per lens

  • S0506

    Bifocal vision prescription lens (safety, athletic, or sunglass), per lens

  • S0508

    Trifocal vision prescription lens (safety, athletic, or sunglass), per lens

  • S0510

    Non-prescription lens (safety, athletic, or sunglass), per lens

  • S0512

    Daily wear specialty contact lens, per lens

  • S0514

    Color contact lens, per lens

  • S0516

    Safety eyeglass frames

  • S0518

    Sunglasses frames

  • S0580

    Polycarbonate lens (list this code in addition to the basic code for the lens)

  • S0581

    Nonstandard lens (list this code in addition to the basic code for the lens)

  • S0590

    Integral lens service, miscellaneous services reported separately

  • S0592

    Comprehensive contact lens evaluation

  • S0812

    Phototherapeutic keratectomy (ptk)

  • V2020

    Frames, purchases

  • V2025

    Deluxe frame

  • V2100

    Sphere, single vision, plano to plus or minus 4.00, per lens

  • V2101

    Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens

  • V2102

    Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens

  • V2103

    Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens

  • V2104

    Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

  • V2105

    Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

  • V2106

    Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens

  • V2107

    Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens

  • V2108

    Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens

  • V2109

    Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens

  • V2110

    Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens

  • V2111

    Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens

  • V2112

    Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens

  • V2113

    Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens

  • V2114

    Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens

  • V2115

    Lenticular, (myodisc), per lens, single vision

  • V2118

    Aniseikonic lens, single vision

  • V2121

    Lenticular lens, per lens, single

  • V2199

    Not otherwise classified, single vision lens

  • V2200

    Sphere, bifocal, plano to plus or minus 4.00d, per lens

  • V2201

    Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens

  • V2202

    Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens

  • V2203

    Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens

  • V2204

    Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

  • V2205

    Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

  • V2206

    Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens

  • V2207

    Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens

  • V2208

    Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens

  • V2209

    Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens

  • V2210

    Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens

  • V2211

    Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens