$348.66
Choose 66820 for a mechanical surgical opening of the secondary membrane; choose 66821 when the treatment is performed with laser.
On this page
CMS RVU26D · Effective 2026-10-01
66820 Secondary cataract Medicare reimbursement rates in Colorado
Report 66820 when an ophthalmologist mechanically opens an opacified capsule or related membrane after cataract surgery rather than using laser treatment. Compare 66820 office and facility rates across CMS payment localities in Colorado.
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 66820 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$438.61
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Ophthalmology
About 66820: Surgical opening of secondary cataract membrane
Report 66820 when an ophthalmologist mechanically opens an opacified capsule or related membrane after cataract surgery rather than using laser treatment.
This procedure creates an opening in a cloudy membrane left behind after cataract surgery, typically the opacified posterior capsule. An ophthalmologist performs the surgical treatment with an instrument rather than a laser. It is used when the membrane interferes with vision and the surgeon chooses a mechanical approach; it is distinct from laser treatment of the same problem and from procedures that remove lens material or reposition an intraocular lens.
Report 66820 for the surgical membrane-opening service, supported by documentation of the secondary opacity, its clinical significance, and the technique 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 the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 66820
- 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 RVU3.91 · 31%
- Practice expense (office) RVU8.41 · 67%
- Malpractice RVU0.29 · 2%
1.8K
Medicare services in 2024 · #2555 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.
66820 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
66820 opens the membrane, while 66830 represents removal of the secondary membrane. Follow the operative technique documented.
No office rate
66825 is for repositioning a displaced intraocular lens, not for opening an opacified capsule.
Compare 66820 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$438.61
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 66820 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,395
- Code
- 66820
- Physician work
- 3.91
- Practice expense
- 8.41
- Malpractice
- 0.29
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.91 | × 1.012 | 3.9569 |
| Practice expense | 8.41 | × 1.064 | 8.9482 |
| Malpractice | 0.29 | × 0.781 | 0.2265 |
| Total RVUs | 13.1317 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$438.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.91 | 1.012 |
| Practice expense | 8.41 | 1.064 |
| Malpractice | 0.29 | 0.781 |
(3.91 × 1.012 + 8.41 × 1.064 + 0.29 × 0.781) × $33.4009 = $438.61
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
66820 billing questions
How does 66820 differ from 66821?
66820 is for a surgical, mechanical opening of the secondary membrane. Use 66821 when the surgeon treats it with laser.
When is 66830 a better fit?
66830 describes removal of a secondary membrane rather than creating an opening in it. The operative report should support the actual technique and work performed.
Does the 90-day global period include postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can 66820 be reported bilaterally?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.
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.
7,39266761,,Revision of iris,A,,2.93,5.81,,2.90,,0.22,8.96,6.05,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39366762,,Revision of iris,A,,5.25,8.75,,5.32,,0.42,14.42,10.99,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39466770,,Removal of inner eye lesion,A,,5.98,9.54,,5.99,,0.47,15.99,12.44,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,39566820,,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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899