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CPT 66986: Lens exchangeMedicare rate & RVUs

Report this service when an ophthalmologist removes an existing intraocular lens and places a replacement, rather than implanting a lens during cataract surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities15.4K Medicare services in 2024

Medicare pays $764.21 for 66986 nationally in a facility.

Medicare rate · 66986

Lens exchange

Swap in your local Medicare rate.

Work RVUs
11.95
Total RVUs
22.88
Global days
090

National rate · 2026

$764.21

Facility setting, before claim adjustments.

See every locality for 66986 →

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

On this page 10 sections
  1. Medicare rate
  2. What 66986 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 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

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

109 of 109 payment localities

66986 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$708.77
Alaska*Unavailable$971.20
ArizonaUnavailable$749.31
ArkansasUnavailable$701.82
AtlantaUnavailable$777.12
AustinUnavailable$780.73
BakersfieldUnavailable$791.39
Baltimore/Surr. CntysUnavailable$802.45
BeaumontUnavailable$731.96
BrazoriaUnavailable$757.42

66986 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
66986 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 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.

How the rate is built · 66986

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.95Practice expense 9.98Malpractice 0.95

22.8800 adjusted RVUs×$33.4009 conversion factor=$764.21

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 66986

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

CMS payment indicators · 66986

Lens exchange

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)1Permitted with supporting documentation.
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 · 66986

Lens exchange

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

66986 without 50 · national facility

$764.21

Lens exchange

66986-50 · Bilateral: 150%

$1,146.32

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

66986 compared with similar codes

Compare codes

66986 vs 66985 vs 66984 vs 66982: national Medicare rates

Swap in your local Medicare rate.

  • 66986
    Lens exchange · 11.95 wRVU
    —
  • 66985
    Lens implantation · 9.73 wRVU
    —
  • 66984
    Cataract surgery · 7.17 wRVU
    —
  • 66982
    Cataract surgery · 9.99 wRVU
    —

How to choose

66985Lens implantation
Choose 66986 when the surgeon removes an existing intraocular lens and replaces it. Choose 66985 for lens implantation without an exchange.
66984Cataract surgery
66984 describes cataract removal with lens implantation in the cataract operation. 66986 describes a later exchange of an implanted lens.
66982Cataract surgery
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.

Codes related to 66986
CodeHow it relatesNational office range
Used instead
66985Lens implantationFor secondary lens implantation when an existing intraocular lens is not exchanged.No office rate
66984Cataract surgeryFor cataract removal with lens implantation, rather than replacement of an existing implant.No office rate
66982Cataract surgeryFor complex cataract removal with lens implantation, not a later lens exchange.No office rate

66986 billing questions

When should 66986 be reported instead of 66985?

Use 66986 when an existing intraocular lens is removed and replaced. Code 66985 describes insertion of a lens prosthesis without that exchange.

Can removal of the old lens and insertion of the replacement be reported separately?

The removal and replacement together constitute the exchange service. The operative note should support both steps.

How does 66986 differ from cataract surgery with lens implantation?

66986 is for exchanging an already implanted lens. Codes 66984 and 66982 describe cataract removal with lens implantation, with 66982 used for complex cataract surgery.

How is bilateral lens exchange paid?

CMS pays a bilateral procedure reported with modifier 50 at 150%.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted. Co-surgeons are paid only with supporting documentation; team surgery is 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 66986PPRRVU2026_Oct_nonQPP.csv, line 7,409 (RVU26D)

Open CMS sourceHow we calculate rates

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