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CPT code 66821: YAG laser capsulotomy, laser discission of secondary membrane2026 Medicare rate & RVUs in Tennessee

Laser opening of an opacified posterior lens capsule or anterior hyaloid membrane after cataract surgery, reported per eye with a 90-day global period.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3M Medicare services in 2024

In Tennessee, Medicare pays $311.84 for 66821 in the office and $257.19 when it’s performed in a hospital or facility.

$311.84Office (non-facility)
$257.19Hospital or facility
−7.0%vs the national office rate ($335.35)

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.

We’ll open 66821 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Tennessee
  2. What 66821 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Tennessee 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. Tennessee pays $311.84. The RVUs are the same everywhere; the geographic indexes change the dollars.

66821 in Tennessee vs other payment areas
  1. Tennessee · this page$311.84
  2. Los Angeles, CA · California$376.59+$64.75
  3. Washington, DC area · District of Columbia$380.70+$68.86
  4. Miami, FL · Florida$356.96+$45.12
  5. Chicago, IL · Illinois$348.02+$36.18
  6. Manhattan, NY · New York$382.31+$70.47
  7. Alaska · Alaska$401.23+$89.39

Other areas in Tennessee first, then benchmark localities. Bars start at $0.

Every other payment area

66821 in every other Medicare payment locality
Payment localityOfficeFacility
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

66821 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
66821 office rate range by state
State / territoryOffice rate rangeLocalities
AK$401.231
AL$304.751
AR$300.871
AZ$327.451
CA$354.08–$439.0829
CO$348.661
CT$355.941
DC$380.701
DE$332.471
FL$330.05–$356.963
GA$313.65–$340.812
GU$361.391
HI$361.391
IA$311.971
ID$313.681
IL$321.27–$348.404
IN$315.301
KS$310.491
KY$310.681
LA$310.18–$323.752
MA$346.87–$380.852
MD$338.36–$380.703
ME$314.93–$330.322
MI$317.65–$333.522
MN$335.721
MO$305.35–$325.003
MS$303.171
MT$335.331
NC$317.871
ND$330.391
NE$313.541
NH$343.151
NJ$360.45–$377.442
NM$319.111
NV$334.171
NY$322.08–$390.405
OH$316.641
OK$310.401
OR$332.00–$358.942
PA$317.19–$347.812
PR$337.591
RI$343.681
SC$317.691
SD$329.801
TN$311.841
TX$315.33–$347.138
UT$321.551
VA$329.22–$380.702
VI$337.591
VT$329.061
WA$346.23–$388.362
WI$320.501
WV$310.681
WY$333.171

See 66821 in every payment locality

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

Office or facility?

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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 66821 in Tennessee
ComponentRVULocality factorAdjusted
Physician work3.33× 1.0003.3300
Practice expense6.46× 0.9095.8721
Malpractice0.25× 0.5370.1343
Total RVUs9.3364
Conversion factor× 33.4009

Office rate, Tennessee$311.84

Office: (3.33 × 1 + 6.46 × 0.909 + 0.25 × 0.537) × $33.4009 = $311.84

Facility: (3.33 × 1 + 4.66 × 0.909 + 0.25 × 0.537) × $33.4009 = $257.19

Open 66821 in the RVU calculator

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

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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 66821

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

Codes related to 66821
CodeHow it relatesOffice range, Tennessee
Used instead
66820Secondary cataract, surgical membrane openingIncisional discission of the secondary membrane with a blade or needle instead of laser.No office rate
66830Lens lesion removal, cyst or tumorSurgical removal of the secondary membrane through a corneoscleral incision instead of laser discission.No office rate
Often billed with
92012Eye exam, intermediate, established patientDistinct intermediate eye examination may support a same-day decision for laser treatment; use modifier 57 when appropriate.$84.70
92014Comprehensive eye exam, established patientDistinct comprehensive eye examination may support a same-day decision for laser treatment; use modifier 57 when appropriate.$119.50

How 66821 has changed in Tennessee

66821 · Office / nonfacility

$311.84

Effective 2026-10-01

The base rate is $16.54 higher than on 2025-10-01, moving from $295.30 to $311.84 (5.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $295.30changed to$311.84

    • 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 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $306.57changed to$295.30

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.31 changed to 6.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $301.57changed to$306.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $308.72changed to$301.57

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.22 changed to 6.31
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544

  5. January 1, 2023

    RVU23A

    $310.29changed to$308.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.08 changed to 6.22
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $312.24changed to$310.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.06 changed to 6.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $313.37changed to$312.24

    • 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 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $314.70changed to$313.37

    • 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 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $313.71changed to$314.70

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.73 changed to 5.75

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$313.71

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$311.84$257.19RVU26D
2026-07-01$311.84$257.19RVU26C
2026-04-01$311.84$257.19RVU26B
2026-01-01$311.84$257.19RVU26A
2025-10-01$295.30$276.46RVU25D
2025-07-01$295.30$276.46RVU25C
2025-04-01$295.30$276.46RVU25B
2025-01-01$295.30$276.46RVU25A
2024-10-01$306.57$285.99RVU24D
2024-07-01$306.57$285.99RVU24C
2024-04-01$306.57$285.99RVU24B
2024-03-09$306.57$285.99RVU24AR
2024-01-01$301.57$281.32RVU24A
2023-10-01$308.72$287.51RVU23D
2023-07-01$308.72$287.51RVU23C
2023-04-01$308.72$287.51RVU23B
2023-01-01$308.72$287.51RVU23A
2022-10-01$310.29$288.37RVU22D
2022-07-01$310.29$288.37RVU22C
2022-04-01$310.29$288.37RVU22B
2022-01-01$310.29$288.37RVU22A
2021-10-01$312.24$290.45RVU21D
2021-07-01$312.24$290.45RVU21C
2021-04-01$312.24$290.45RVU21B
2021-01-01$312.24$290.45RVU21A
2020-10-01$313.37$294.27RVU20D
2020-07-01$313.37$294.27RVU20C
2020-04-01$313.37$294.27RVU20B
2020-01-01$313.37$294.27RVU20A
2019-10-01$314.70$296.19RVU19D
2019-07-01$314.70$296.19RVU19C
2019-04-01$314.70$296.19RVU19B
2019-01-01$314.70$296.19RVU19A
2018-10-01$313.71$296.52RVU18D
2018-07-01$313.71$296.52RVU18C
2018-04-01$313.71$296.52RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 66821 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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
RVUs for 66821PPRRVU2026_Oct_nonQPP.csv, line 7,396 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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