CPT code 66986: Lens exchange, removal and replacement2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 66986 in California.

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

What 66986 covers

An ophthalmologist removes an implanted intraocular lens and places a replacement during a reoperation on the eye. The service is appropriate when the existing implant must be exchanged, rather than when a cataract is removed and an intraocular lens is placed during the original cataract operation. It is generally performed in an ophthalmic operating room, such as a hospital outpatient department or ambulatory surgery center.

Report the exchange when the operative record supports removal of the existing implant and placement of its replacement. Documentation should identify the eye, the reason the original lens required replacement, and the work performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is 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 66986 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 of 29 payment localities

How the 66986 rate is calculated

Each of 66986’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.

Payment rules and modifiers for 66986

66986 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

66986 compared with similar codes

How to choose

66985Lens implantationSecondary implant

Choose 66986 when the surgeon removes an existing intraocular lens and replaces it. Choose 66985 for lens implantation without an exchange.

66984Cataract surgeryStandard, without ECP or drainage device

66984 describes cataract removal with lens implantation in the cataract operation. 66986 describes a later exchange of an implanted lens.

66982Cataract surgeryComplex, without ECP

66982 is for complex cataract removal with lens implantation; 66986 is for removing and replacing an existing intraocular lens.

Codes related to 66986

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

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

Open CMS sourceHow we calculate rates