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Billing code 66990: Ophthalmic endoscopyMedicare rate & RVUs

Reports use of an ophthalmic endoscope as an adjunct to a primary eye procedure, such as when endoscopic visualization or treatment is performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities86 Medicare services in 2024

Medicare pays $70.48 for 66990 nationally in a facility.

Medicare rate · 66990

Ophthalmic endoscopy

Swap in your local Medicare rate.

Work RVUs
1.47
Total RVUs
2.11
Global days
ZZZ

National rate · 2026

$70.48

Facility setting, before claim adjustments.

See every locality for 66990 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 66990 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 66990 covers

This add-on identifies use of an ophthalmic endoscope during another eye operation, such as to visualize or deliver treatment to structures that are difficult to see directly. Ophthalmic surgeons may use it for endoscopic photocoagulation or other endoscope-assisted work during procedures involving the anterior segment or ciliary body. It describes the endoscope use, not the primary operation itself.

Report 66990 only with a qualifying primary procedure; it is not a standalone service. The operative report should identify the primary procedure and explain the endoscope’s use and the tissue or treatment target. CMS treats payment for this add-on as within the primary procedure’s global period. Do not use it to separately represent work already included in the primary procedure’s description.

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 66990 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

66990 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$66.57
Alaska*Unavailable$94.35
ArizonaUnavailable$69.36
ArkansasUnavailable$66.08
AtlantaUnavailable$71.71
AustinUnavailable$71.12
BakersfieldUnavailable$71.51
Baltimore/Surr. CntysUnavailable$73.48
BeaumontUnavailable$68.63
BrazoriaUnavailable$69.83

66990 rates by state

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

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Explore a state

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
66990 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 66990 rate is calculated

Each of 66990’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 · 66990

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.47Practice expense 0.52Malpractice 0.12

2.1100 adjusted RVUs×$33.4009 conversion factor=$70.48

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

Payment rules and modifiers for 66990

The CMS indicators that decide how 66990 is paid alongside other services.

CMS payment indicators · 66990

Ophthalmic endoscopy

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

66990 compared with similar codes

Compare codes

66990 vs 66984 vs 66982 vs 66988 vs 66987: national Medicare rates

Swap in your local Medicare rate.

  • 66990
    Ophthalmic endoscopy · 1.47 wRVU
    —
  • 66984
    Cataract surgery · 7.17 wRVU
    —
  • 66982
    Cataract surgery · 9.99 wRVU
    —
  • 66988
    · 0 wRVU
    —
  • 66987
    · 0 wRVU
    —

How to choose

66984Cataract surgery
66984 represents routine cataract surgery with lens implantation. 66990 is an add-on for qualifying ophthalmic endoscope use and cannot replace the cataract procedure code.
66982Cataract surgery
66982 represents complex cataract surgery with lens implantation. Use 66990 only when endoscope use is also documented as a separately reportable adjunct.
66988Xcapsl ctrc rmvl w/ecp
66988 describes cataract surgery with endoscopic cyclophotocoagulation. Distinguish that defined combined service from other primary procedures involving separately reportable endoscope use.
66987Xcapsl ctrc rmvl cplx w/ecp
66987 is the complex cataract-surgery counterpart to 66988, with endoscopic cyclophotocoagulation included in the combined service. It is not interchangeable with the endoscope-use add-on.

Codes related to 66990

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

Codes related to 66990
CodeHow it relatesNational office range
Add-on codes
66984Cataract surgeryRoutine cataract surgery may be the primary procedure when qualifying endoscope use is performed.No office rate
66982Cataract surgeryComplex cataract surgery may be the primary procedure when qualifying endoscope use is performed.No office rate
66983Cataract surg w/iol 1 stageCataract extraction with lens implantation may serve as the primary procedure.No office rate

66990 billing questions

Can 66990 be billed by itself?

No. It is an add-on and must be reported with a primary procedure.

What should the operative note show?

Document the primary operation, that an ophthalmic endoscope was used, and its role in visualization or treatment.

Is 66990 the cataract procedure code?

No. A cataract procedure such as 66984 or 66982 represents the primary surgery; 66990 identifies qualifying endoscope use in addition to that procedure.

How does the global period affect payment?

CMS pays 66990 within the global period of the primary procedure with which it is reported.

Is endoscopic cyclophotocoagulation always reported with 66990?

No. Choose codes based on the actual procedure performed and the applicable code description; document whether endoscope use is separately represented by the primary procedure.

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 66990PPRRVU2026_Oct_nonQPP.csv, line 7,413 (RVU26D)

Open CMS sourceHow we calculate rates

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