CPT code 66991: Cataract surgery, with endoscopic cyclophotocoagulation2026 Medicare rate & RVUs in California
Reports cataract extraction with intraocular lens implantation performed in the same session as endoscopic cyclophotocoagulation for a patient with glaucoma.
CMS doesn’t publish an office rate for 66991 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.
Your location
On this page 9 sections
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 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 | $603.70 |
| Chico, CA | Unavailable | $601.41 |
| El Centro, CA | Unavailable | $601.53 |
| Fresno, CA | Unavailable | $601.41 |
| Hanford, CA | Unavailable | $601.41 |
| Los Angeles, CA | Unavailable | $634.07 |
| Madera, CA | Unavailable | $601.41 |
| Marin County, CA | Unavailable | $704.26 |
| Merced, CA | Unavailable | $601.41 |
| Modesto, CA | Unavailable | $601.41 |
| Napa, CA | Unavailable | $671.99 |
| Oxnard, CA | Unavailable | $628.96 |
| Redding, CA | Unavailable | $601.41 |
| Rest of California | Unavailable | $601.41 |
| Riverside, CA | Unavailable | $609.02 |
| Sacramento, CA | Unavailable | $624.45 |
| Salinas, CA | Unavailable | $621.91 |
| San Benito County, CA | Unavailable | $718.82 |
| San Diego, CA | Unavailable | $631.31 |
| San Francisco, CA | Unavailable | $703.48 |
| San Luis Obispo, CA | Unavailable | $612.53 |
| Santa Clara County, CA | Unavailable | $715.61 |
| Santa Cruz, CA | Unavailable | $633.38 |
| Santa Maria, CA | Unavailable | $622.82 |
| Santa Rosa, CA | Unavailable | $639.45 |
| Stockton, CA | Unavailable | $601.41 |
| Vallejo, CA | Unavailable | $670.86 |
| Visalia, CA | Unavailable | $601.41 |
| Yuba City, CA | Unavailable | $601.41 |
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
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
| 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 · 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.
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).
66991 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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?
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
Fee sheets · Coming soon
Put 66991 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist