V2627 — Scleral cover shell
V2627 is a HCPCS Level II code for scleral cover shell. It belongs to the Vision, Hearing and Speech-Language Pathology section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of V2627 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
- DME supplier
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for V2627
- Long descriptor
- Scleral cover shell
- Short descriptor
- Scleral cover shell
- Added
- January 1, 1993
- BETOS
- D1F
- Pricing indicator
- 38 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to V2627
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If V2627 is not quite right, the correct code is very often within a few positions of it.
- V2599Contact lens, other type
- V2600Hand held low vision aids and other nonspectacle mounted aids
- V2610Single lens spectacle mounted low vision aids
- V2615Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound microscopic lens system
- V2623Prosthetic eye, plastic, custom
- V2624Polishing/resurfacing of ocular prosthesis
- V2625Enlargement of ocular prosthesis
- V2626Reduction of ocular prosthesis
- V2628Fabrication and fitting of ocular conformer
- V2629Prosthetic eye, other type
- V2630Anterior chamber intraocular lens
- V2631Iris supported intraocular lens
- V2632Posterior chamber intraocular lens
- V2700Balance lens, per lens
- V2702Deluxe lens feature
- V2710Slab off prism, glass or plastic, per lens
Questions about V2627
What is HCPCS code V2627?
V2627 is a HCPCS Level II code for scleral cover shell. It sits in the Vision, Hearing and Speech-Language Pathology section.
Does Medicare cover V2627?
The CMS HCPCS file marks V2627 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is V2627 paid under the physician fee schedule?
V2627 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.