# HCPCS V2104: Spherocylindr 4.00d/2.12-4d

Medicare HCPCS V2104 pays $51.98 on average under the 2026 Q4 Medicare DMEPOS Fee Schedule (non-rural). State amounts run from $46.12 in Vermont to $61.49 in New Jersey, a 33% spread.

Web page: https://www.med-reveal.com/rates/V2104-hcpcs-fee-schedule
Section: Vision and Hearing Services
Billed by: Ophthalmology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $51.98 |
| National facility | $51.98 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| New Jersey | $61.49 | $61.49 |
| New York | $61.49 | $61.49 |
| Virgin Islands | $61.49 | $61.49 |
| Delaware | $60.16 | $60.16 |
| District of Columbia | $60.16 | $60.16 |
| Maryland | $60.16 | $60.16 |
| Pennsylvania | $60.16 | $60.16 |
| Virginia | $60.16 | $60.16 |
| West Virginia | $60.16 | $60.16 |
| Colorado | $58.76 | $58.76 |
| Montana | $58.76 | $58.76 |
| North Dakota | $58.76 | $58.76 |
| South Dakota | $58.76 | $58.76 |
| Utah | $58.76 | $58.76 |
| Wyoming | $58.76 | $58.76 |
| Puerto Rico | $58.09 | $58.09 |
| Idaho | $53.60 | $53.60 |
| Oregon | $53.60 | $53.60 |
| Washington | $53.60 | $53.60 |
| Hawaii | $53.00 | $53.00 |
| Arkansas | $52.70 | $52.70 |
| Louisiana | $52.70 | $52.70 |
| New Mexico | $52.70 | $52.70 |
| Oklahoma | $52.70 | $52.70 |
| Texas | $52.70 | $52.70 |
| Alaska | $49.52 | $49.52 |
| Illinois | $49.39 | $49.39 |
| Indiana | $49.39 | $49.39 |
| Michigan | $49.39 | $49.39 |
| Minnesota | $49.39 | $49.39 |
| Ohio | $49.39 | $49.39 |
| Wisconsin | $49.39 | $49.39 |
| Arizona | $48.44 | $48.44 |
| California | $48.44 | $48.44 |
| Nevada | $48.44 | $48.44 |
| Alabama | $46.12 | $46.12 |
| Connecticut | $46.12 | $46.12 |
| Florida | $46.12 | $46.12 |
| Georgia | $46.12 | $46.12 |
| Iowa | $46.12 | $46.12 |
| Kansas | $46.12 | $46.12 |
| Kentucky | $46.12 | $46.12 |
| Maine | $46.12 | $46.12 |
| Massachusetts | $46.12 | $46.12 |
| Mississippi | $46.12 | $46.12 |
| Missouri | $46.12 | $46.12 |
| Nebraska | $46.12 | $46.12 |
| New Hampshire | $46.12 | $46.12 |
| North Carolina | $46.12 | $46.12 |
| Rhode Island | $46.12 | $46.12 |
| South Carolina | $46.12 | $46.12 |
| Tennessee | $46.12 | $46.12 |
| Vermont | $46.12 | $46.12 |

## Related codes

- V2025: Eyeglasses delux frames — https://www.med-reveal.com/rates/V2025-hcpcs-fee-schedule
- V2105: Spherocylinder 4.00d/4.25-6d — https://www.med-reveal.com/rates/V2105-hcpcs-fee-schedule
- V2106: Spherocylinder 4.00d/>6.00d — https://www.med-reveal.com/rates/V2106-hcpcs-fee-schedule
- V2107: Spherocylinder 4.25d/12-2d — https://www.med-reveal.com/rates/V2107-hcpcs-fee-schedule
- V2108: Spherocylinder 4.25d/2.12-4d — https://www.med-reveal.com/rates/V2108-hcpcs-fee-schedule
- V2109: Spherocylinder 4.25d/4.25-6d — https://www.med-reveal.com/rates/V2109-hcpcs-fee-schedule
- V2110: Spherocylinder 4.25d/over 6d — https://www.med-reveal.com/rates/V2110-hcpcs-fee-schedule
- V2111: Spherocylindr 7.25d/.25-2.25 — https://www.med-reveal.com/rates/V2111-hcpcs-fee-schedule

Commercial negotiated rates for V2104 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules