No office rate
66820 treats a secondary cataract membrane by incision. This code is for removal of a discrete lesion involving the natural lens.
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CMS RVU26D · Effective 2026-10-01
66830 Lens lesion removal Medicare reimbursement rates in California
Report this service when an ophthalmic surgeon surgically removes a discrete lesion, such as a cyst or tumor, involving the eye’s natural lens. Compare 66830 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 66830 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$623.31–$745.70
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $122.39 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 66830 pays more and less in California
Ophthalmic surgery
About 66830: Surgical removal of a lens lesion
Report this service when an ophthalmic surgeon surgically removes a discrete lesion, such as a cyst or tumor, involving the eye’s natural lens.
An ophthalmic surgeon uses this code for surgical removal of a discrete lesion involving the natural lens, such as a lens cyst or tumor. The operative target is the lesion itself, rather than a secondary cataract membrane or lens material removed as part of cataract surgery. The procedure is typically performed in a surgical setting, with the surgeon documenting the lesion and the removal performed.
Select the code based on the operative report’s description of a lens lesion and its removal. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 66830
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.23 · 51%
- Practice expense (office) RVU8.11 · 45%
- Malpractice RVU0.72 · 4%
521
Medicare services in 2024 · #3527 by national volume
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.
66830 compared with similar codes
Office rates for California, from the same CMS release.
$354.08–$439.08
66821 uses laser treatment for a secondary cataract. This code describes surgical removal of a lens lesion, such as a cyst or tumor.
No office rate
66840 describes aspiration of lens material. Choose this code when the operative target is a discrete lens lesion instead.
No office rate
66850 describes removal of lens material by phacofragmentation; this code is for removal of a lens lesion.
Compare 66830 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $625.68 |
| Chico | Office Unavailable | Facility $623.31 |
| El Centro | Office Unavailable | Facility $623.43 |
| Fresno | Office Unavailable | Facility $623.31 |
| Hanford-Corcoran | Office Unavailable | Facility $623.31 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $657.35 |
| Madera | Office Unavailable | Facility $623.31 |
| Merced | Office Unavailable | Facility $623.31 |
| Modesto | Office Unavailable | Facility $623.31 |
| Napa | Office Unavailable | Facility $696.95 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $652.09 |
| Redding | Office Unavailable | Facility $623.31 |
| Rest Of California | Office Unavailable | Facility $623.31 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $631.24 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $647.31 |
| Salinas | Office Unavailable | Facility $644.69 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $654.55 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $730.56 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $729.74 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $745.70 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $742.36 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $634.96 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $656.78 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $645.66 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $663.07 |
| Stockton | Office Unavailable | Facility $623.31 |
| Vallejo | Office Unavailable | Facility $695.77 |
| Visalia | Office Unavailable | Facility $623.31 |
| Yuba City | Office Unavailable | Facility $623.31 |
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66830 billing questions
How is this code different from lens-material removal codes?
Use this code when the surgeon removes a discrete lesion involving the natural lens. Codes for lens-material removal describe procedures directed at lens material rather than a cyst or tumor.
Does the global period include postoperative care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
Report bilateral surgery with modifier 50. CMS pays 150% for the bilateral procedure.
Can an assistant surgeon be paid for this procedure?
CMS does not pay assistant-at-surgery services for this code. Co-surgeons and team surgery are also not permitted.
What documentation supports reporting this code?
The operative report should identify the discrete lens lesion, such as a cyst or tumor, and describe its surgical removal. Documentation should distinguish that target from a secondary cataract membrane or lens material.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,39566820,,Incision secondary cataract,A,,3.91,8.41,NA,8.41,,0.29,12.61,12.61,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39666821,,After cataract laser surgery,A,,3.33,6.46,,4.66,,0.25,10.04,8.24,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39766825,,Reposition intraocular lens,A,,8.78,12.39,NA,12.39,,0.69,21.86,21.86,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39866830,,Removal of lens lesion,A,,9.23,8.11,NA,8.11,,0.72,18.06,18.06,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39966840,,Removal of lens material,A,,8.95,8.02,NA,8.02,,0.71,17.68,17.68,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40066850,,Removal of lens material,A,,10.29,8.95,NA,8.95,,0.82,20.06,20.06,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40166852,,Removal of lens material,A,,11.12,9.25,NA,9.25,,0.89,21.26,21.26,0,090,0.10,0.70,0.20,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00