#370 of 11K

V2103

Lens, sphere-cylinder, single vision, plus or minus 4.00

Lens, sphere-cylinder, single vision, plus or minus 4.00 is the #370 most-billed Medicaid procedure code, with $326.7M in payments across 20.9M claims from 2018–2024. The national median cost per claim is $18.82. Costs vary widely — the 90th percentile is $41.29 per claim, 2.2× the median.

Total Paid

$326.7M

0.03% of all spending

Total Claims

20.9M

Providers

10K

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for V2103? Based on 9K providers billing this code nationally.

Median

$18.82

Average

$21.75

Std Dev

$13.77

Max

$150.49

Percentile Distribution (Cost per Claim)

p10

$7.36

p25

$12.42

Median

$18.82

p75

$27.45

p90

$41.29

p95

$51.01

p99

$64.08

50% of providers bill between $12.42 and $27.45 per claim for this code.

90% bill between $7.36 and $41.29.

Top 1% bill above $64.08.

About This Procedure

HCPCS code V2103 (Lens, sphere-cylinder, single vision, plus or minus 4.00) was billed by 10K providers across 20.9M claims, totaling $326.7M in Medicaid payments from 2018–2024. This code was used for 17.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$18.82

Providers Billing

National Spending

$326.7M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for V2103

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Classic Optical Laboratories, Inc. Youngstown, OH · Technician/Technologist, Ocularist	$31.4M	$8.30	0.4× median	Below Median
2	1649487729	$17.6M	$13.04	0.7× median	Below Median
3	1588871669	$12.7M	$13.11	0.7× median	Below Median
4	1376576777	$9.4M	$8.13	0.4× median	Below Median
5	1518598952	$6.5M	$13.89	0.7× median	Below Median
6	1417156589	$4.1M	$8.73	0.5× median	Below Median
7	1386077832	$3.6M	$20.61	1.1× median	Above Median
8	1780896332	$2.5M	$7.56	0.4× median	Below Median
9	1295808012	$2.4M	$16.12	0.9× median	Below Median
10	1326472945	$1.8M	$26.39	1.4× median	Above Median
11	1033161195	$1.8M	$50.71	2.7× median	Top 10%
12	1407051279	$1.7M	$15.22	0.8× median	Below Median
13	Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization	$1.7M	$51.95	2.8× median	Top 10%
14	1639339930	$1.6M	$40.90	2.2× median	Above 75th
15	1770648297	$1.3M	$36.93	2.0× median	Above 75th
16	1972789071	$1.2M	$61.16	3.2× median	Top 10%
17	1487750683	$1.1M	$51.80	2.8× median	Top 10%
18	1205995388	$1.1M	$19.52	1.0× median	Above Median
19	1174734560	$1.1M	$43.48	2.3× median	Top 10%
20	1962762765	$1.1M	$43.15	2.3× median	Top 10%

Showing top 20 of 10K providers billing this code

Related Procedures

V2100Lens, sphere, single vision, plus or minus 4.00$343.7M V2104$41.7M V2107$14.8M V2105$8.1M V2101$4.2M

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