# HCPCS V2623: Prosthetic eye, plastic, custom

Medicare HCPCS V2623 pays $1,238.60 on average under the 2026 Q4 Medicare DMEPOS Fee Schedule (non-rural). State amounts run from $904.18 in Puerto Rico to $1,984.14 in Hawaii, a 119% spread.

Web page: https://www.med-reveal.com/rates/V2623-hcpcs-fee-schedule
Section: Vision and Hearing Services

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $1,238.60 |
| National facility | $1,238.60 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Hawaii | $1,984.14 | $1,984.14 |
| Alaska | $1,855.60 | $1,855.60 |
| Arizona | $1,465.24 | $1,465.24 |
| Arkansas | $1,465.24 | $1,465.24 |
| California | $1,465.24 | $1,465.24 |
| Louisiana | $1,465.24 | $1,465.24 |
| Nevada | $1,465.24 | $1,465.24 |
| New Mexico | $1,465.24 | $1,465.24 |
| Oklahoma | $1,465.24 | $1,465.24 |
| Texas | $1,465.24 | $1,465.24 |
| New Jersey | $1,418.85 | $1,418.85 |
| New York | $1,418.85 | $1,418.85 |
| Virgin Islands | $1,418.85 | $1,418.85 |
| Idaho | $1,317.13 | $1,317.13 |
| Oregon | $1,317.13 | $1,317.13 |
| Washington | $1,317.13 | $1,317.13 |
| Iowa | $1,183.70 | $1,183.70 |
| Kansas | $1,183.70 | $1,183.70 |
| Missouri | $1,183.70 | $1,183.70 |
| Nebraska | $1,183.70 | $1,183.70 |
| Colorado | $1,162.77 | $1,162.77 |
| Montana | $1,162.77 | $1,162.77 |
| North Dakota | $1,162.77 | $1,162.77 |
| South Dakota | $1,162.77 | $1,162.77 |
| Utah | $1,162.77 | $1,162.77 |
| Wyoming | $1,162.77 | $1,162.77 |
| Connecticut | $1,158.14 | $1,158.14 |
| Maine | $1,158.14 | $1,158.14 |
| Massachusetts | $1,158.14 | $1,158.14 |
| New Hampshire | $1,158.14 | $1,158.14 |
| Rhode Island | $1,158.14 | $1,158.14 |
| Vermont | $1,158.14 | $1,158.14 |
| Illinois | $1,154.43 | $1,154.43 |
| Indiana | $1,154.43 | $1,154.43 |
| Michigan | $1,154.43 | $1,154.43 |
| Minnesota | $1,154.43 | $1,154.43 |
| Ohio | $1,154.43 | $1,154.43 |
| Wisconsin | $1,154.43 | $1,154.43 |
| Alabama | $1,098.93 | $1,098.93 |
| Delaware | $1,098.93 | $1,098.93 |
| District of Columbia | $1,098.93 | $1,098.93 |
| Florida | $1,098.93 | $1,098.93 |
| Georgia | $1,098.93 | $1,098.93 |
| Kentucky | $1,098.93 | $1,098.93 |
| Maryland | $1,098.93 | $1,098.93 |
| Mississippi | $1,098.93 | $1,098.93 |
| North Carolina | $1,098.93 | $1,098.93 |
| Pennsylvania | $1,098.93 | $1,098.93 |
| South Carolina | $1,098.93 | $1,098.93 |
| Tennessee | $1,098.93 | $1,098.93 |
| Virginia | $1,098.93 | $1,098.93 |
| West Virginia | $1,098.93 | $1,098.93 |
| Puerto Rico | $904.18 | $904.18 |

## Related codes

- 92340: Fitting of spectacles, except aphakia, monofocal — https://www.med-reveal.com/rates/92340-cpt-fee-schedule
- 92341: Fitting of spectacles, except aphakia, multifocal, other than bifocal — https://www.med-reveal.com/rates/92341-cpt-fee-schedule
- 92352: Fitting of spectacle prosthesis for aphakia, monofocal — https://www.med-reveal.com/rates/92352-cpt-fee-schedule
- V2624: Polishing/resurfacing of ocular prosthesis — https://www.med-reveal.com/rates/V2624-hcpcs-fee-schedule
- V2625: Enlargement of ocular prosthesis — https://www.med-reveal.com/rates/V2625-hcpcs-fee-schedule
- V2626: Reduction of ocular prosthesis — https://www.med-reveal.com/rates/V2626-hcpcs-fee-schedule
- V2627: Scleral cover shell — https://www.med-reveal.com/rates/V2627-hcpcs-fee-schedule
- V2629: Prosthetic eye, other type — https://www.med-reveal.com/rates/V2629-hcpcs-fee-schedule

Commercial negotiated rates for V2623 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