CPT code 66821: YAG laser capsulotomy, laser discission of secondary membrane2026 Medicare rate & RVUs in California
Laser opening of an opacified posterior lens capsule or anterior hyaloid membrane after cataract surgery, reported per eye with a 90-day global period.
Medicare pays $354.08–$439.08 for 66821 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 66821 covers
This procedure treats clouding of the posterior lens capsule behind an intraocular lens after cataract extraction. An ophthalmologist uses a laser, usually an Nd:YAG laser, to create an opening that clears the visual axis. The target may include an opacified anterior hyaloid membrane. Treatment is commonly performed in an ophthalmology office or ambulatory surgery center without a surgical incision.
Select 66821 for laser discission of the secondary membrane, including one or more stages needed to complete the capsulotomy; document the affected eye, examination findings, reason for treatment, and laser procedure. Report unilateral treatment with the appropriate laterality modifier. For treatment of both eyes, Medicare pays bilateral reporting with modifier 50 at 150%. Medicare assigns a 90-day global period that includes the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment is statutorily 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 66821 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$354.08 to $439.08
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $354.91 | $289.01 |
| Chico, CA | $354.08 | $288.18 |
| El Centro, CA | $354.12 | $288.22 |
| Fresno, CA | $354.08 | $288.18 |
| Hanford, CA | $354.08 | $288.18 |
| Los Angeles, CA | $376.59 | $305.46 |
| Madera, CA | $354.08 | $288.18 |
| Marin County, CA | $429.86 | $345.09 |
| Merced, CA | $354.08 | $288.18 |
| Modesto, CA | $354.08 | $288.18 |
| Napa, CA | $406.86 | $327.62 |
| Oxnard, CA | $374.58 | $303.52 |
| Redding, CA | $354.08 | $288.18 |
| Rest of California | $354.08 | $288.18 |
| Riverside, CA | $356.83 | $290.94 |
| Sacramento, CA | $370.65 | $300.72 |
| Salinas, CA | $369.23 | $299.54 |
| San Benito County, CA | $439.08 | $352.38 |
| San Diego, CA | $377.15 | $305.24 |
| San Francisco, CA | $429.58 | $344.80 |
| San Luis Obispo, CA | $363.35 | $294.87 |
| Santa Clara County, CA | $437.91 | $351.22 |
| Santa Cruz, CA | $380.20 | $307.15 |
| Santa Maria, CA | $370.40 | $300.30 |
| Santa Rosa, CA | $384.00 | $310.17 |
| Stockton, CA | $354.08 | $288.18 |
| Vallejo, CA | $406.45 | $327.21 |
| Visalia, CA | $354.08 | $288.18 |
| Yuba City, CA | $354.08 | $288.18 |
How the 66821 rate is calculated
Each of 66821’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 · 66821
RVUs × geographic indexes × conversion factor
Work3.33
3.33 RVUs× 1.000 GPCI
Practice expense6.46
6.46 RVUs× 1.000 GPCI
Malpractice0.25
0.25 RVUs× 1.000 GPCI
Adjusted RVUs
10.0400
Conversion factor
$33.4009
Medicare rate
$335.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 66821
66821 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 66821
YAG laser capsulotomy, laser discission of secondary membrane
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 66821
YAG laser capsulotomy, laser discission of secondary membrane
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
66821 without 50 · national office
$335.35
YAG laser capsulotomy, laser discission of secondary membrane
66821-50 · Bilateral: 150%
$503.03
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).
66821 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 66820Secondary cataractSurgical membrane opening
- 66820 opens the secondary membrane using an incisional technique with a blade or needle; 66821 opens it with a laser.
- 66761Laser iridotomyPeripheral iris opening
- 66761 creates a laser opening in the iris, often for angle-closure risk; 66821 targets a secondary membrane along the visual axis after cataract surgery.
- 66830Lens lesion removalCyst or tumor
- 66830 surgically removes the secondary membrane through a corneoscleral incision; 66821 opens the membrane with a laser.
- 66984Cataract surgeryStandard, without ECP or drainage device
- 66984 removes the original cataract and implants an intraocular lens; 66821 treats later membrane clouding that obstructs the visual axis.
66821 billing questions
Can additional laser sessions on the same eye be billed while completing the opening?
Do not report each stage needed to complete the same capsulotomy as a separate service. The code encompasses one or more stages.
Is modifier 79 automatic if treatment occurs during the cataract surgery global period?
No. Posterior capsule opacity after cataract extraction is not automatically an unrelated condition. Determine whether a separate procedure is reportable during the original surgeon's global period before selecting a postoperative modifier.
Can an eye examination on the day of laser treatment be billed?
Routine preoperative evaluation is included. A separately documented examination that results in the decision to perform this major procedure may be reported with modifier 57.
How is treatment of both eyes reported?
Use RT or LT for one eye. When both eyes are treated, Medicare's bilateral rule provides for modifier 50 and payment at 150%.
Is a surgical assistant payable for this procedure?
No. Medicare has a statutory restriction on assistant-at-surgery payment for 66821; co-surgeons and team surgery are not permitted.
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
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