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CPT code 66991: Cataract surgery, with endoscopic cyclophotocoagulation2026 Medicare rate & RVUs

Reports cataract extraction with intraocular lens implantation performed in the same session as endoscopic cyclophotocoagulation for a patient with glaucoma.

CMS RVU26DEffective Oct 1, 2026109 payment localities171.8K Medicare services in 2024

Medicare pays $582.18 for 66991 nationally in a facility.

Medicare rate · 66991

Cataract surgery, with endoscopic cyclophotocoagulation

Office or facility?

Work RVUs
9
Total RVUs
17.43
Global days
090

National rate · 2026

$582.18

Facility setting, before claim adjustments.

See every locality for 66991 →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 66991 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 66991 covers

An ophthalmologist reports this combined service when removing a cataract, implanting an intraocular lens, and performing endoscopic cyclophotocoagulation (ECP) during the same operative session. ECP uses an endoscope to visualize and treat the ciliary processes; the combined approach is used for patients who have both a visually significant cataract and glaucoma. These procedures are typically performed in an ambulatory surgery center or hospital outpatient operating room.

The record should support the cataract extraction, lens implantation, and ECP, including the clinical indications and operative work performed. Choose this code when the cataract procedure includes ECP; use a cataract code without ECP when that treatment is not performed. CMS assigns a 90-day 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 payment is restricted, and 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 66991 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

66991 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$539.86
AlaskaUnavailable$738.94
ArizonaUnavailable$570.84
ArkansasUnavailable$534.55
Atlanta, GAUnavailable$591.85
Austin, TXUnavailable$595.15
Bakersfield, CAUnavailable$603.70
Baltimore area, MDUnavailable$611.32
Beaumont, TXUnavailable$557.27
Brazoria, TXUnavailable$577.19

66991 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
66991 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 66991 rate is calculated

Each of 66991’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 · 66991

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.00

9.00 RVUs× 1.000 GPCI

Practice expense7.74

7.74 RVUs× 1.000 GPCI

Malpractice0.69

0.69 RVUs× 1.000 GPCI

Adjusted RVUs

17.4300

Conversion factor

$33.4009

Medicare rate

$582.18

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

Payment rules and modifiers for 66991

66991 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66991

Cataract surgery, with endoscopic cyclophotocoagulation

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 · 66991

Cataract surgery, with endoscopic cyclophotocoagulation

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

66991 without 50 · national facility

$582.18

Cataract surgery, with endoscopic cyclophotocoagulation

66991-50 · Bilateral: 150%

$873.27

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

66991 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 66991

    Cataract surgery, with endoscopic cyclophotocoagulation9 wRVU

    Not priced

  • 66984

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

    Not priced

  • 66982

    Cataract surgery, complex, without ECP9.99 wRVU

    Not priced

  • 66989

    Cataract surgery, complex with drainage device11.83 wRVU

    Not priced

How to choose

66984Cataract surgeryStandard, without ECP or drainage device
Use 66984 for cataract extraction with lens implantation without ECP. This code includes ECP performed in the same session.
66982Cataract surgeryComplex, without ECP
Use 66982 for complex cataract surgery without ECP. This code describes the combined cataract, lens implantation, and ECP service.
66989Cataract surgeryComplex with drainage device
66989 is the complex cataract counterpart with ECP; this code is used when the cataract procedure does not meet complex-service criteria.

Codes related to 66991

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

Codes related to 66991
CodeHow it relatesNational office range
Same family
66989Cataract surgery, complex with drainage deviceComplex cataract surgery with ECP; select when the complex-service criteria are met.No office rate
Used instead
66984Cataract surgery, standard, without ECP or drainage deviceCataract extraction with lens implantation when ECP is not performed.No office rate
66982Cataract surgery, complex, without ECPComplex cataract extraction with lens implantation when ECP is not performed.No office rate

66991 billing questions

How does this differ from routine cataract surgery with an intraocular lens?

This code includes ECP performed during the cataract and lens implantation session. A cataract code without ECP is used when ECP is not performed.

Does this code include the ECP treatment?

Yes. The code represents cataract extraction, lens implantation, and ECP performed together; document each part of the operative service.

When should the complex cataract variant be considered?

Use the complex variant when the operative circumstances meet the criteria for complex cataract surgery and ECP is also performed. Do not select it solely because the patient has glaucoma.

What postoperative care is included?

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

How is bilateral surgery reported under the CMS rules provided?

For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant surgeon or co-surgeon be paid?

Assistant-at-surgery payment is restricted for this code. 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 66991PPRRVU2026_Oct_nonQPP.csv, line 7,414 (RVU26D)

Open CMS sourceHow we calculate rates

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