Billing code 66852: Lens removalMedicare rate & RVUs in Illinois
Reports posterior-approach removal of lens material, often retained fragments after cataract surgery, with vitrectomy performed when needed.
CMS doesn’t publish an office rate for 66852 in Illinois.
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 9 sections
What 66852 covers
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.
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 66852 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $752.74 |
| East St. Louis | Unavailable | $715.53 |
| Rest Of Illinois | Unavailable | $699.96 |
| Suburban Chicago | Unavailable | $743.99 |
How the 66852 rate is calculated
Each of 66852’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 · 66852
RVUs × geographic indexes × conversion factor
Work11.12
11.12 RVUs× 1.000 GPCI
Practice expense9.25
9.25 RVUs× 1.000 GPCI
Malpractice0.89
0.89 RVUs× 1.000 GPCI
Adjusted RVUs
21.2600
Conversion factor
$33.4009
Medicare rate
$710.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 66852
66852 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 66852
Lens removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 66852
Lens removal
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
66852 without 50 · national facility
$710.10
Lens removal
66852-50 · Bilateral: 150%
$1,065.15
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).
66852 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 66840Lens aspiration
- 66840 describes lens-material removal by aspiration; 66852 is selected when the surgeon uses the pars plana approach.
- 66850Lens removal
- 66850 describes removal using phacofragmentation with aspiration. Use 66852 for pars plana removal of lens material.
- 66830Lens lesion removal
- 66830 addresses removal of a secondary membranous cataract, not retained lens material removed through a pars plana approach.
- 67036Vitrectomy
- 67036 describes pars plana vitrectomy. With 66852, vitrectomy performed as part of lens-material removal is included; 67036 concerns vitrectomy work without that lens-material removal.
66852 billing questions
When should 66852 be chosen over 66840 or 66850?
Choose 66852 when lens material is removed through a pars plana approach. Codes 66840 and 66850 describe other lens-material removal techniques; the operative approach and technique distinguish them.
Can vitrectomy be reported separately with 66852?
Vitrectomy performed as part of the pars plana lens-material removal is included, whether or not it is performed. Do not report a separate vitrectomy code solely for that work.
Does 66852 include postoperative visits?
Yes. Its 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral 66852 reported?
Use modifier 50 for a bilateral procedure; Medicare pays the bilateral service at 150%.
What documentation supports assistant-at-surgery or co-surgeon payment?
The record must support medical necessity for an assistant at surgery. Co-surgeon payment also requires supporting documentation.
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
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