CPT code 66821: YAG laser capsulotomy, laser discission of secondary membrane2026 Medicare rate & RVUs in Miami, FL
Laser opening of an opacified posterior lens capsule or anterior hyaloid membrane after cataract surgery, reported per eye with a 90-day global period.
In Miami, FL, Medicare pays $356.96 for 66821 in the office and $294.37 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 66821 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How Miami, FL compares for 66821
Across 109 of 109 payment localities, the office rate for 66821 runs from $300.87 in Arkansas to $439.08 in San Benito County, CA. Miami, FL pays $356.96. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Miami, FL · this page$356.96
- Fort Lauderdale, FL · Florida$344.90−$12.06
- Rest of Florida · Florida$330.05−$26.91
- Los Angeles, CA · California$376.59+$19.63
- Washington, DC area · District of Columbia$380.70+$23.74
- Chicago, IL · Illinois$348.02−$8.94
- Manhattan, NY · New York$382.31+$25.35
Other areas in Florida first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $401.23 | $337.20 |
| AlabamaAlabama | $304.75 | $252.14 |
| ArkansasArkansas | $300.87 | $249.23 |
| ArizonaArizona | $327.45 | $269.20 |
| Bakersfield, CACalifornia | $354.91 | $289.01 |
| Chico, CACalifornia | $354.08 | $288.18 |
| El Centro, CACalifornia | $354.12 | $288.22 |
| Fresno, CACalifornia | $354.08 | $288.18 |
| Hanford, CACalifornia | $354.08 | $288.18 |
| Madera, CACalifornia | $354.08 | $288.18 |
| Merced, CACalifornia | $354.08 | $288.18 |
| Modesto, CACalifornia | $354.08 | $288.18 |
| Napa, CACalifornia | $406.86 | $327.62 |
| Oxnard, CACalifornia | $374.58 | $303.52 |
| Redding, CACalifornia | $354.08 | $288.18 |
| Rest of CaliforniaCalifornia | $354.08 | $288.18 |
| Riverside, CACalifornia | $356.83 | $290.94 |
| Sacramento, CACalifornia | $370.65 | $300.72 |
| Salinas, CACalifornia | $369.23 | $299.54 |
| San Diego, CACalifornia | $377.15 | $305.24 |
| Marin County, CACalifornia | $429.86 | $345.09 |
| San Francisco, CACalifornia | $429.58 | $344.80 |
| San Benito County, CACalifornia | $439.08 | $352.38 |
| Santa Clara County, CACalifornia | $437.91 | $351.22 |
| San Luis Obispo, CACalifornia | $363.35 | $294.87 |
| Santa Cruz, CACalifornia | $380.20 | $307.15 |
| Santa Maria, CACalifornia | $370.40 | $300.30 |
| Santa Rosa, CACalifornia | $384.00 | $310.17 |
| Stockton, CACalifornia | $354.08 | $288.18 |
| Vallejo, CACalifornia | $406.45 | $327.21 |
| Visalia, CACalifornia | $354.08 | $288.18 |
| Yuba City, CACalifornia | $354.08 | $288.18 |
| ColoradoColorado | $348.66 | $284.69 |
| ConnecticutConnecticut | $355.94 | $291.19 |
| DelawareDelaware | $332.47 | $273.07 |
| Atlanta, GAGeorgia | $340.81 | $279.73 |
| Rest of GeorgiaGeorgia | $313.65 | $260.02 |
| Hawaii, Guam, HIHawaii | $361.39 | $293.03 |
| IowaIowa | $311.97 | $256.96 |
| IdahoIdaho | $313.68 | $258.37 |
| East St. Louis, ILIllinois | $326.55 | $271.24 |
| Rest of IllinoisIllinois | $321.27 | $266.38 |
| Suburban Chicago, ILIllinois | $348.40 | $286.65 |
| IndianaIndiana | $315.30 | $259.57 |
| KansasKansas | $310.49 | $256.14 |
| KentuckyKentucky | $310.68 | $257.24 |
| New Orleans, LALouisiana | $323.75 | $267.18 |
| Rest of LouisianaLouisiana | $310.18 | $256.97 |
| Metropolitan Boston, MAMassachusetts | $380.85 | $309.06 |
| Rest of MassachusettsMassachusetts | $346.87 | $283.56 |
| Baltimore area, MDMaryland | $354.85 | $290.34 |
| Rest of MarylandMaryland | $338.36 | $277.52 |
| Rest of MaineMaine | $314.93 | $259.62 |
| Southern Maine, MEMaine | $330.32 | $270.74 |
| Detroit, MIMichigan | $333.52 | $275.50 |
| Rest of MichiganMichigan | $317.65 | $262.76 |
| MinnesotaMinnesota | $335.72 | $273.86 |
| Metropolitan Kansas City, MOMissouri | $321.99 | $265.54 |
| Metropolitan St. Louis, MOMissouri | $325.00 | $267.77 |
| Rest of MissouriMissouri | $305.35 | $253.53 |
| MississippiMississippi | $303.17 | $251.41 |
| MontanaMontana | $335.33 | $275.21 |
| North CarolinaNorth Carolina | $317.87 | $261.78 |
| North DakotaNorth Dakota | $330.39 | $270.26 |
| NebraskaNebraska | $313.54 | $258.04 |
| New HampshireNew Hampshire | $343.15 | $280.56 |
| Northern New JerseyNew Jersey | $377.44 | $307.70 |
| Rest of New JerseyNew Jersey | $360.45 | $294.80 |
| New MexicoNew Mexico | $319.11 | $263.98 |
| NevadaNevada | $334.17 | $273.98 |
| NYC suburbs and Long Island, NYNew York | $390.40 | $318.92 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $362.60 | $296.77 |
| Queens, NYNew York | $385.42 | $314.36 |
| Rest of New YorkNew York | $322.08 | $264.96 |
| OhioOhio | $316.64 | $261.75 |
| OklahomaOklahoma | $310.40 | $256.71 |
| Portland, OROregon | $358.94 | $292.14 |
| Rest of OregonOregon | $332.00 | $272.12 |
| Metropolitan Philadelphia, PAPennsylvania | $347.81 | $285.22 |
| Rest of PennsylvaniaPennsylvania | $317.19 | $262.00 |
| Puerto RicoPuerto Rico | $337.59 | $276.81 |
| Rhode IslandRhode Island | $343.68 | $281.57 |
| South CarolinaSouth Carolina | $317.69 | $262.14 |
| South DakotaSouth Dakota | $329.80 | $269.68 |
| TennesseeTennessee | $311.84 | $257.19 |
| Austin, TXTexas | $347.13 | $283.52 |
| Beaumont, TXTexas | $315.33 | $260.62 |
| Brazoria, TXTexas | $332.46 | $272.88 |
| Dallas, TXTexas | $334.30 | $274.42 |
| Fort Worth, TXTexas | $332.25 | $272.97 |
| Galveston, TXTexas | $333.29 | $273.59 |
| Houston, TXTexas | $337.86 | $278.16 |
| Rest of TexasTexas | $323.53 | $266.48 |
| UtahUtah | $321.55 | $265.03 |
| VirginiaVirginia | $329.22 | $270.12 |
| Virgin Islands, VIUnited States Virgin Islands | $337.59 | $276.81 |
| VermontVermont | $329.06 | $269.54 |
| Rest of WashingtonWashington | $346.23 | $282.92 |
| King County, WAWashington | $388.36 | $314.59 |
| WisconsinWisconsin | $320.50 | $262.91 |
| West VirginiaWest Virginia | $310.68 | $258.43 |
| WyomingWyoming | $333.17 | $273.05 |
66821 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$300.87
$401.23
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $401.23 | 1 |
| AL | $304.75 | 1 |
| AR | $300.87 | 1 |
| AZ | $327.45 | 1 |
| CA | $354.08–$439.08 | 29 |
| CO | $348.66 | 1 |
| CT | $355.94 | 1 |
| DC | $380.70 | 1 |
| DE | $332.47 | 1 |
| FL | $330.05–$356.96 | 3 |
| GA | $313.65–$340.81 | 2 |
| GU | $361.39 | 1 |
| HI | $361.39 | 1 |
| IA | $311.97 | 1 |
| ID | $313.68 | 1 |
| IL | $321.27–$348.40 | 4 |
| IN | $315.30 | 1 |
| KS | $310.49 | 1 |
| KY | $310.68 | 1 |
| LA | $310.18–$323.75 | 2 |
| MA | $346.87–$380.85 | 2 |
| MD | $338.36–$380.70 | 3 |
| ME | $314.93–$330.32 | 2 |
| MI | $317.65–$333.52 | 2 |
| MN | $335.72 | 1 |
| MO | $305.35–$325.00 | 3 |
| MS | $303.17 | 1 |
| MT | $335.33 | 1 |
| NC | $317.87 | 1 |
| ND | $330.39 | 1 |
| NE | $313.54 | 1 |
| NH | $343.15 | 1 |
| NJ | $360.45–$377.44 | 2 |
| NM | $319.11 | 1 |
| NV | $334.17 | 1 |
| NY | $322.08–$390.40 | 5 |
| OH | $316.64 | 1 |
| OK | $310.40 | 1 |
| OR | $332.00–$358.94 | 2 |
| PA | $317.19–$347.81 | 2 |
| PR | $337.59 | 1 |
| RI | $343.68 | 1 |
| SC | $317.69 | 1 |
| SD | $329.80 | 1 |
| TN | $311.84 | 1 |
| TX | $315.33–$347.13 | 8 |
| UT | $321.55 | 1 |
| VA | $329.22–$380.70 | 2 |
| VI | $337.59 | 1 |
| VT | $329.06 | 1 |
| WA | $346.23–$388.36 | 2 |
| WI | $320.50 | 1 |
| WV | $310.68 | 1 |
| WY | $333.17 | 1 |
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.
The exact Miami, FL inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,396
- Code
- 66821
- Physician work
- 3.33
- Practice expense
- 6.46
- Malpractice
- 0.25
GPCI2026.csv
42
- Locality
- Miami, FL
- Physician work
- 1.000
- Practice expense
- 1.041
- Malpractice
- 2.529
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.33 | × 1.000 | 3.3300 |
| Practice expense | 6.46 | × 1.041 | 6.7249 |
| Malpractice | 0.25 | × 2.529 | 0.6322 |
| Total RVUs | 10.6871 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Miami, FL$356.96
Office: (3.33 × 1 + 6.46 × 1.041 + 0.25 × 2.529) × $33.4009 = $356.96
Facility: (3.33 × 1 + 4.66 × 1.041 + 0.25 × 2.529) × $33.4009 = $294.37
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).
How 66821 has changed in Miami, FL
66821 · Office / nonfacility
$356.96
Effective 2026-10-01
The base rate is $19.49 higher than on 2025-10-01, moving from $337.47 to $356.96 (5.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$337.47changed to$356.96
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.42 changed to 3.33
- Practice expense RVU 6.22 changed to 6.46
- Practice expense GPCI 1.027 changed to 1.041
- Malpractice GPCI 2.500 changed to 2.529
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$350.36changed to$337.47
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 6.31 changed to 6.22
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$344.64changed to$350.36
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$353.66changed to$344.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 6.22 changed to 6.31
- Practice expense GPCI 1.025 changed to 1.027
- Malpractice GPCI 2.564 changed to 2.500
January 1, 2023
RVU23A
$356.34changed to$353.66
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 6.08 changed to 6.22
- Practice expense GPCI 1.023 changed to 1.025
- Malpractice GPCI 2.629 changed to 2.564
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$358.58changed to$356.34
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 6.06 changed to 6.08
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$359.60changed to$358.58
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 5.72 changed to 6.06
- Malpractice RVU 0.26 changed to 0.25
- Practice expense GPCI 1.026 changed to 1.023
- Malpractice GPCI 2.598 changed to 2.629
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$359.61changed to$359.60
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 5.75 changed to 5.72
- Malpractice RVU 0.25 changed to 0.26
- Practice expense GPCI 1.029 changed to 1.026
- Malpractice GPCI 2.566 changed to 2.598
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$358.47changed to$359.61
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 5.73 changed to 5.75
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$354.85changed to$358.47
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 5.66 changed to 5.73
- Practice expense GPCI 1.031 changed to 1.029
- Malpractice GPCI 2.528 changed to 2.566
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$354.08changed to$354.85
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 1.033 changed to 1.031
- Malpractice GPCI 2.490 changed to 2.528
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$355.51changed to$354.08
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 5.64 changed to 5.66
- Malpractice RVU 0.26 changed to 0.25
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$353.74changed to$355.51
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$381.54changed to$353.74
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 5.63 changed to 5.64
- Malpractice RVU 0.51 changed to 0.26
- Practice expense GPCI 1.044 changed to 1.033
- Malpractice GPCI 2.653 changed to 2.490
Held through RVU15B.
January 1, 2014
RVU14A
$389.09changed to$381.54
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.19 changed to 5.63
- Malpractice RVU 0.53 changed to 0.51
- Practice expense GPCI 1.054 changed to 1.044
- Malpractice GPCI 2.815 changed to 2.653
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $389.09
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $356.96 | $294.37 | RVU26D |
| 2026-07-01 | $356.96 | $294.37 | RVU26C |
| 2026-04-01 | $356.96 | $294.37 | RVU26B |
| 2026-01-01 | $356.96 | $294.37 | RVU26A |
| 2025-10-01 | $337.47 | $315.88 | RVU25D |
| 2025-07-01 | $337.47 | $315.88 | RVU25C |
| 2025-04-01 | $337.47 | $315.88 | RVU25B |
| 2025-01-01 | $337.47 | $315.88 | RVU25A |
| 2024-10-01 | $350.36 | $326.77 | RVU24D |
| 2024-07-01 | $350.36 | $326.77 | RVU24C |
| 2024-04-01 | $350.36 | $326.77 | RVU24B |
| 2024-03-09 | $350.36 | $326.77 | RVU24AR |
| 2024-01-01 | $344.64 | $321.44 | RVU24A |
| 2023-10-01 | $353.66 | $329.35 | RVU23D |
| 2023-07-01 | $353.66 | $329.35 | RVU23C |
| 2023-04-01 | $353.66 | $329.35 | RVU23B |
| 2023-01-01 | $353.66 | $329.35 | RVU23A |
| 2022-10-01 | $356.34 | $331.21 | RVU22D |
| 2022-07-01 | $356.34 | $331.21 | RVU22C |
| 2022-04-01 | $356.34 | $331.21 | RVU22B |
| 2022-01-01 | $356.34 | $331.21 | RVU22A |
| 2021-10-01 | $358.58 | $333.60 | RVU21D |
| 2021-07-01 | $358.58 | $333.60 | RVU21C |
| 2021-04-01 | $358.58 | $333.60 | RVU21B |
| 2021-01-01 | $358.58 | $333.60 | RVU21A |
| 2020-10-01 | $359.60 | $337.76 | RVU20D |
| 2020-07-01 | $359.60 | $337.76 | RVU20C |
| 2020-04-01 | $359.60 | $337.76 | RVU20B |
| 2020-01-01 | $359.60 | $337.76 | RVU20A |
| 2019-10-01 | $359.61 | $338.47 | RVU19D |
| 2019-07-01 | $359.61 | $338.47 | RVU19C |
| 2019-04-01 | $359.61 | $338.47 | RVU19B |
| 2019-01-01 | $359.61 | $338.47 | RVU19A |
| 2018-10-01 | $358.47 | $338.84 | RVU18D |
| 2018-07-01 | $358.47 | $338.84 | RVU18C |
| 2018-04-01 | $358.47 | $338.84 | RVU18B |
| 2018-01-01 | $358.47 | $338.84 | RVU18AR1 |
| 2017-10-01 | $354.85 | $335.61 | RVU17D |
| 2017-07-01 | $354.85 | $335.61 | RVU17C |
| 2017-04-01 | $354.85 | $335.61 | RVU17B |
| 2017-01-01 | $354.85 | $335.61 | RVU17A |
| 2016-10-01 | $354.08 | $334.85 | RVU16D |
| 2016-07-01 | $354.08 | $334.85 | RVU16C |
| 2016-04-01 | $354.08 | $334.85 | RVU16B |
| 2016-01-01 | $354.08 | $334.85 | RVU16A |
| 2015-10-01 | $355.51 | $336.21 | RVU15D |
| 2015-07-01 | $355.51 | $336.21 | RVU15C |
| 2015-04-01 | $353.74 | $334.53 | RVU15B |
| 2015-01-01 | $353.74 | $334.53 | RVU15A |
| 2014-10-01 | $381.54 | $362.84 | RVU14D |
| 2014-07-01 | $381.54 | $362.84 | RVU14C |
| 2014-04-01 | $381.54 | $362.84 | RVU14B |
| 2014-01-01 | $381.54 | $362.84 | RVU14A |
| 2013-10-01 | $389.09 | $368.30 | RVU13D |
| 2013-07-01 | $389.09 | $368.30 | RVU13C |
| 2013-04-01 | $389.09 | $368.30 | RVU13B |
| 2013-01-01 | $389.09 | $368.30 | RVU13AR |
Where the Miami, FL rate applies
Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.
- Miami
- Aventura
- Bal Harbour
- Bay Harbor Islands
- Big Coppitt Key
- Big Pine Key
- Biscayne Gardens
- Biscayne Park
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
Show the CMS file lines behind this rate
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