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CPT code 66989: Cataract surgery, complex with drainage device2026 Medicare rate & RVUs

Reports complex cataract removal with intraocular lens placement combined with internal insertion of an aqueous drainage device into the trabecular meshwork.

CMS RVU26DEffective Oct 1, 2026109 payment localities17.1K Medicare services in 2024

Medicare pays $718.79 for 66989 nationally in a facility.

Medicare rate · 66989

Cataract surgery, complex with drainage device

Office or facility?

Work RVUs
11.83
Total RVUs
21.52
Global days
090

National rate · 2026

$718.79

Facility setting, before claim adjustments.

See every locality for 66989 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 66989 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 66989 covers

An ophthalmologist removes the cataract, places an intraocular lens during the same procedure, and inserts an aqueous drainage device internally into the trabecular meshwork to improve aqueous outflow. The cataract portion must be complex, involving a device or technique not generally used in routine surgery; examples include an iris expansion device, suture support for the lens implant, or primary posterior capsulorrhexis. These combined procedures are typically performed in an operating room at an ambulatory surgery center or hospital.

Report this code when both the complex cataract procedure and the specified trabecular drainage-device insertion are performed. The operative record should support the complex technique or device and document the lens implantation and drainage-device placement. CMS assigns a 90-day major-surgery global period, including 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 others at 50%; bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are subject to statutory nonpayment; 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 66989 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

66989 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$668.84
AlaskaUnavailable$921.60
ArizonaUnavailable$705.28
ArkansasUnavailable$662.58
Atlanta, GAUnavailable$730.84
Austin, TXUnavailable$733.06
Bakersfield, CAUnavailable$742.40
Baltimore area, MDUnavailable$753.78
Beaumont, TXUnavailable$690.24
Brazoria, TXUnavailable$712.55

66989 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
66989 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 66989 rate is calculated

Each of 66989’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 · 66989

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.83

11.83 RVUs× 1.000 GPCI

Practice expense8.77

8.77 RVUs× 1.000 GPCI

Malpractice0.92

0.92 RVUs× 1.000 GPCI

Adjusted RVUs

21.5200

Conversion factor

$33.4009

Medicare rate

$718.79

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 66989

66989 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66989

Cataract surgery, complex with drainage device

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 · 66989

Cataract surgery, complex with drainage device

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

66989 without 50 · national facility

$718.79

Cataract surgery, complex with drainage device

66989-50 · Bilateral: 150%

$1,078.19

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

66989 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 66989

    Cataract surgery, complex with drainage device11.83 wRVU

    Not priced

  • 66991

    Cataract surgery, with endoscopic cyclophotocoagulation9 wRVU

    Not priced

  • 66982

    Cataract surgery, complex, without ECP9.99 wRVU

    Not priced

  • 66987

    Cataract surgery, complex, with ECP0 wRVU

    Not priced

  • 66984

    Cataract surgery, standard, without ECP or drainage device7.17 wRVU

    Not priced

How to choose

66991Cataract surgeryWith endoscopic cyclophotocoagulation
Both combine cataract surgery with internal trabecular drainage-device insertion. Choose 66989 only when the cataract portion meets complex criteria.
66982Cataract surgeryComplex, without ECP
This code covers complex cataract removal with lens implantation but not the trabecular drainage-device insertion included in 66989.
66987Cataract surgeryComplex, with ECP
Both involve complex cataract surgery, but 66987 combines it with endoscopic cyclophotocoagulation rather than trabecular drainage-device insertion.
66984Cataract surgeryStandard, without ECP or drainage device
66984 is for routine cataract removal with lens implantation; 66989 includes complex-cataract criteria and trabecular drainage-device insertion.

Codes related to 66989

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

Codes related to 66989
CodeHow it relatesNational office range
Same family
66991Cataract surgery, with endoscopic cyclophotocoagulationCombined cataract surgery and trabecular drainage-device insertion without complex-cataract criteria.No office rate
66982Cataract surgery, complex, without ECPComplex cataract removal with lens implantation, without the trabecular drainage-device insertion.No office rate
Used instead
66987Cataract surgery, complex, with ECPComplex cataract surgery combined with endoscopic cyclophotocoagulation rather than trabecular device insertion.No office rate
66988Cataract surgery, with ECP, noncomplexRoutine cataract surgery combined with endoscopic cyclophotocoagulation.No office rate
66984Cataract surgery, standard, without ECP or drainage deviceRoutine cataract removal with lens implantation without the combined drainage-device procedure.No office rate

66989 billing questions

When should this code be chosen over 66991?

Use 66989 when the cataract procedure meets the complex criteria and the trabecular drainage device is inserted. Code 66991 describes the corresponding combined procedure without the complex-cataract criteria.

Can the cataract removal and drainage-device insertion be billed separately?

The code represents the combined complex cataract and trabecular drainage-device procedure. Do not separately report the cataract portion as though the combined service had not been performed.

What documentation supports the complex designation?

Document the specific device or technique that made cataract surgery complex, such as an iris expansion device, suture support for the lens implant, or primary posterior capsulorrhexis.

How is bilateral surgery reported under the CMS rules?

For bilateral procedures reported with modifier 50, CMS pays 150%.

What postoperative care is included?

The 90-day major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 66989PPRRVU2026_Oct_nonQPP.csv, line 7,412 (RVU26D)

Open CMS sourceHow we calculate rates

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