CPT code 66989: Cataract surgery, complex with drainage device2026 Medicare rate & RVUs in California
Reports complex cataract removal with intraocular lens placement combined with internal insertion of an aqueous drainage device into the trabecular meshwork.
CMS doesn’t publish an office rate for 66989 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.
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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 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
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $742.40 |
| Chico, CA | Unavailable | $739.37 |
| El Centro, CA | Unavailable | $739.52 |
| Fresno, CA | Unavailable | $739.37 |
| Hanford, CA | Unavailable | $739.37 |
| Los Angeles, CA | Unavailable | $778.27 |
| Madera, CA | Unavailable | $739.37 |
| Marin County, CA | Unavailable | $859.80 |
| Merced, CA | Unavailable | $739.37 |
| Modesto, CA | Unavailable | $739.37 |
| Napa, CA | Unavailable | $821.71 |
| Oxnard, CA | Unavailable | $771.58 |
| Redding, CA | Unavailable | $739.37 |
| Rest of California | Unavailable | $739.37 |
| Riverside, CA | Unavailable | $749.50 |
| Sacramento, CA | Unavailable | $766.50 |
| Salinas, CA | Unavailable | $763.35 |
| San Benito County, CA | Unavailable | $877.47 |
| San Diego, CA | Unavailable | $773.98 |
| San Francisco, CA | Unavailable | $858.76 |
| San Luis Obispo, CA | Unavailable | $751.96 |
| Santa Clara County, CA | Unavailable | $873.20 |
| Santa Cruz, CA | Unavailable | $775.81 |
| Santa Maria, CA | Unavailable | $764.22 |
| Santa Rosa, CA | Unavailable | $783.17 |
| Stockton, CA | Unavailable | $739.37 |
| Vallejo, CA | Unavailable | $820.21 |
| Visalia, CA | Unavailable | $739.37 |
| Yuba City, CA | Unavailable | $739.37 |
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
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
| 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 · 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.
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).
66989 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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