66852 Lens removal Medicare reimbursement rates in California

An ophthalmologist, often a vitreoretinal surgeon, uses a pars plana approach to remove lens material from inside the eye. A common situation is retained or dropped cataract fragments that require posterior-segment access; vitrectomy may be performed as part of that removal. The procedure is typically done in an operating room or ambulatory surgery center, rather than as routine cataract extraction through an anterior approach.

Select this code for lens-material removal by the pars plana route, not based solely on whether vitrectomy was performed. The operative report should identify the lens material removed and the approach; vitrectomy needed for that removal is included. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery and co-surgeon payment require supporting documentation; team surgery is not permitted.