Billing code 66985: Lens implantationMedicare rate & RVUs in Guam

Reports placement of an intraocular lens in an aphakic eye after the natural lens was removed in an earlier procedure.

CMS RVU26DEffective Oct 1, 20261 payment locality5.4K Medicare services in 2024

CMS doesn’t publish an office rate for 66985 in Guam.

—Office (non-facility)
$689.66Hospital or facility

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

We’ll open 66985 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Guam
  2. What 66985 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 66985 covers

An ophthalmologist uses this service to place an intraocular lens in an eye that lacks its natural lens, typically after cataract extraction or other prior lens removal. It represents a later implant procedure, rather than lens placement during the same operation as cataract removal. The procedure is commonly performed in an operating room or ambulatory surgery center; the surgeon documents the eye’s lens status and the method used to position and secure the implant.

Report the code for the secondary implant, with laterality supported in the operative record. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted by statute; co-surgeon payment requires 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.

66985 in Hawaii, Guam

66985 office and facility rates by payment locality
Payment localityOfficeFacility
Hawaii, GuamUnavailable$689.66

How the 66985 rate is calculated

Each of 66985’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 · 66985

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.73Practice expense 9.20Malpractice 0.79

19.7200 adjusted RVUs×$33.4009 conversion factor=$658.67

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

Payment rules and modifiers for 66985

66985 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66985

Lens implantation

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 · 66985

Lens implantation

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

66985 without 50 · national facility

$658.67

Lens implantation

66985-50 · Bilateral: 150%

$988.01

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

66985 compared with similar codes

Compare codes

66985 vs 66984 vs 66986 vs 66982: national Medicare rates

Swap in your local Medicare rate.

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

How to choose

66984Cataract surgery
Use 66984 when cataract removal and lens implantation occur in the same operation. Use 66985 for lens placement after the natural lens was removed previously.
66986Lens exchange
66986 describes exchange of an existing intraocular lens. 66985 describes secondary implantation when an intraocular lens is absent.
66982Cataract surgery
66982 is for complex cataract removal with lens implantation in the same operation; 66985 is for a later implant procedure.

66985 billing questions

How is this different from 66984?

66985 is for implanting a lens after the natural lens was removed in an earlier procedure. 66984 describes cataract removal with lens implantation during the same operation.

When would 66986 be considered instead?

66986 is for exchanging an existing intraocular lens. Use 66985 when the eye needs a secondary implant rather than replacement of an implant already in place.

What documentation supports 66985?

Document the eye’s aphakic status, the reason for secondary implantation, laterality, and operative details of lens placement and fixation.

How does the bilateral payment rule work?

CMS pays 150% when the bilateral procedure is reported with modifier 50. The operative documentation should support treatment of both eyes.

What postoperative care is included?

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

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 66985PPRRVU2026_Oct_nonQPP.csv, line 7,408 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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