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

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 King County, WA, Medicare pays $388.36 for 66821 in the office and $314.59 when it’s performed in a hospital or facility.

$388.36Office (non-facility)
$314.59Hospital or facility
+15.8%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 King County, WA
  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 King County, WA 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. King County, WA pays $388.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

66821 in King County, WA vs other payment areas
  1. King County, WA · this page$388.36
  2. Rest of Washington · Washington$346.23−$42.13
  3. Los Angeles, CA · California$376.59−$11.77
  4. Washington, DC area · District of Columbia$380.70−$7.66
  5. Miami, FL · Florida$356.96−$31.40
  6. Chicago, IL · Illinois$348.02−$40.34
  7. Manhattan, NY · New York$382.31−$6.05

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

Every other payment area

66821 in every other Medicare payment locality
Payment localityOfficeFacility
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

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 66821 in King County, WA
ComponentRVULocality factorAdjusted
Physician work3.33× 1.0503.4965
Practice expense6.46× 1.2277.9264
Malpractice0.25× 0.8170.2042
Total RVUs11.6272
Conversion factor× 33.4009

Office rate, King County, WA$388.36

Office: (3.33 × 1.05 + 6.46 × 1.227 + 0.25 × 0.817) × $33.4009 = $388.36

Facility: (3.33 × 1.05 + 4.66 × 1.227 + 0.25 × 0.817) × $33.4009 = $314.59

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, King County, WA
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.$105.21
92014Comprehensive eye exam, established patientDistinct comprehensive eye examination may support a same-day decision for laser treatment; use modifier 57 when appropriate.$147.20

How 66821 has changed in King County, WA

66821 · Office / nonfacility

$388.36

Effective 2026-10-01

The base rate is $20.62 higher than on 2025-10-01, moving from $367.74 to $388.36 (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

    $367.74changed to$388.36

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $382.09changed to$367.74

    • 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

    $375.85changed to$382.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $381.73changed to$375.85

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.22 changed to 6.31
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $380.55changed to$381.73

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.08 changed to 6.22
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $382.87changed to$380.55

    • 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

    $376.79changed to$382.87

    • 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
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $372.45changed to$376.79

    • 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
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $371.22changed to$372.45

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

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $366.13changed to$371.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.66 changed to 5.73
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $364.01changed to$366.13

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $364.67changed to$364.01

    • 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.

  13. July 1, 2015

    RVU15C

    $362.85changed to$364.67

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $370.08changed to$362.85

    • 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 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $376.08changed to$370.08

    • 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 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $376.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$388.36$314.59RVU26D
2026-07-01$388.36$314.59RVU26C
2026-04-01$388.36$314.59RVU26B
2026-01-01$388.36$314.59RVU26A
2025-10-01$367.74$342.09RVU25D
2025-07-01$367.74$342.09RVU25C
2025-04-01$367.74$342.09RVU25B
2025-01-01$367.74$342.09RVU25A
2024-10-01$382.09$354.07RVU24D
2024-07-01$382.09$354.07RVU24C
2024-04-01$382.09$354.07RVU24B
2024-03-09$382.09$354.07RVU24AR
2024-01-01$375.85$348.29RVU24A
2023-10-01$381.73$353.10RVU23D
2023-07-01$381.73$353.10RVU23C
2023-04-01$381.73$353.10RVU23B
2023-01-01$381.73$353.10RVU23A
2022-10-01$380.55$351.21RVU22D
2022-07-01$380.55$351.21RVU22C
2022-04-01$380.55$351.21RVU22B
2022-01-01$380.55$351.21RVU22A
2021-10-01$382.87$353.71RVU21D
2021-07-01$382.87$353.71RVU21C
2021-04-01$382.87$353.71RVU21B
2021-01-01$382.87$353.71RVU21A
2020-10-01$376.79$351.88RVU20D
2020-07-01$376.79$351.88RVU20C
2020-04-01$376.79$351.88RVU20B
2020-01-01$376.79$351.88RVU20A
2019-10-01$372.45$348.91RVU19D
2019-07-01$372.45$348.91RVU19C
2019-04-01$372.45$348.91RVU19B
2019-01-01$372.45$348.91RVU19A
2018-10-01$371.22$349.35RVU18D
2018-07-01$371.22$349.35RVU18C
2018-04-01$371.22$349.35RVU18B
2018-01-01$371.22$349.35RVU18AR1
2017-10-01$366.13$344.65RVU17D
2017-07-01$366.13$344.65RVU17C
2017-04-01$366.13$344.65RVU17B
2017-01-01$366.13$344.65RVU17A
2016-10-01$364.01$342.50RVU16D
2016-07-01$364.01$342.50RVU16C
2016-04-01$364.01$342.50RVU16B
2016-01-01$364.01$342.50RVU16A
2015-10-01$364.67$343.09RVU15D
2015-07-01$364.67$343.09RVU15C
2015-04-01$362.85$341.38RVU15B
2015-01-01$362.85$341.38RVU15A
2014-10-01$370.08$349.48RVU14D
2014-07-01$370.08$349.48RVU14C
2014-04-01$370.08$349.48RVU14B
2014-01-01$370.08$349.48RVU14A
2013-10-01$376.08$353.51RVU13D
2013-07-01$376.08$353.51RVU13C
2013-04-01$376.08$353.51RVU13B
2013-01-01$376.08$353.51RVU13AR

Price 66821 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 66821 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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