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CPT code 66820: Secondary cataract, surgical membrane opening2026 Medicare rate & RVUs

Report 66820 when an ophthalmologist mechanically opens an opacified capsule or related membrane after cataract surgery rather than using laser treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.8K Medicare services in 2024

Medicare pays $421.19 for 66820 nationally in a facility.

Medicare rate · 66820

Secondary cataract, surgical membrane opening

Office or facility?

Work RVUs
3.91
Total RVUs
12.61
Global days
090

National rate · 2026

$421.19

Facility setting, before claim adjustments.

See every locality for 66820 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 66820 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 66820 covers

This procedure creates an opening in a cloudy membrane left behind after cataract surgery, typically the opacified posterior capsule. An ophthalmologist performs the surgical treatment with an instrument rather than a laser. It is used when the membrane interferes with vision and the surgeon chooses a mechanical approach; it is distinct from laser treatment of the same problem and from procedures that remove lens material or reposition an intraocular lens.

Report 66820 for the surgical membrane-opening service, supported by documentation of the secondary opacity, its clinical significance, and the technique performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 66820 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

66820 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$381.87
AlaskaUnavailable$500.39
ArizonaUnavailable$411.08
ArkansasUnavailable$376.88
Atlanta, GAUnavailable$428.02
Austin, TXUnavailable$436.63
Bakersfield, CAUnavailable$446.85
Baltimore area, MDUnavailable$446.08
Beaumont, TXUnavailable$395.22
Brazoria, TXUnavailable$417.57

66820 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
66820 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 66820 rate is calculated

Each of 66820’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 66820

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.91

3.91 RVUs× 1.000 GPCI

Practice expense8.41

8.41 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

12.6100

Conversion factor

$33.4009

Medicare rate

$421.19

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 66820

66820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66820

Secondary cataract, surgical membrane opening

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 66820

Secondary cataract, surgical membrane opening

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

66820 without 50 · national facility

$421.19

Secondary cataract, surgical membrane opening

66820-50 · Bilateral: 150%

$631.79

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

66820 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 66820

    Secondary cataract, surgical membrane opening3.91 wRVU

    Not priced

  • 66821

    YAG laser capsulotomy, laser discission of secondary membrane3.33 wRVU

    $335.35

  • 66830

    Lens lesion removal, cyst or tumor9.23 wRVU

    Not priced

  • 66825

    Lens repositioning, intraocular lens implant8.78 wRVU

    Not priced

How to choose

66821YAG laser capsulotomyLaser discission of secondary membrane
Choose 66820 for a mechanical surgical opening of the secondary membrane; choose 66821 when the treatment is performed with laser.
66830Lens lesion removalCyst or tumor
66820 opens the membrane, while 66830 represents removal of the secondary membrane. Follow the operative technique documented.
66825Lens repositioningIntraocular lens implant
66825 is for repositioning a displaced intraocular lens, not for opening an opacified capsule.

Codes related to 66820

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 66820
CodeHow it relatesNational office range
Used instead
66821YAG laser capsulotomy, laser discission of secondary membraneTreats secondary capsular opacity with laser rather than a surgical mechanical technique.$300.87–$439.08
Same family
66830Lens lesion removal, cyst or tumorAddresses secondary membrane opacity by removal rather than by creating an opening.No office rate

66820 billing questions

How does 66820 differ from 66821?

66820 is for a surgical, mechanical opening of the secondary membrane. Use 66821 when the surgeon treats it with laser.

When is 66830 a better fit?

66830 describes removal of a secondary membrane rather than creating an opening in it. The operative report should support the actual technique and work performed.

Does the 90-day global period include postoperative care?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.

Can 66820 be reported bilaterally?

CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 66820PPRRVU2026_Oct_nonQPP.csv, line 7,395 (RVU26D)

Open CMS sourceHow we calculate rates

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