No office rate
Use 66984 for cataract extraction with lens implantation without ECP. This code includes ECP performed in the same session.
On this page
CMS RVU26D · Effective 2026-10-01
66991 Cataract surgery Medicare reimbursement rates in Iowa
Reports cataract extraction with intraocular lens implantation performed in the same session as endoscopic cyclophotocoagulation for a patient with glaucoma. Compare 66991 office and facility rates across CMS payment localities in Iowa.
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 66991 in Iowa?
Iowa 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
$546.31
1 of 1 localities have a supported rate.
Payment area: Iowa
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 66991: Cataract extraction with lens implant and ECP
Reports cataract extraction with intraocular lens implantation performed in the same session as endoscopic cyclophotocoagulation for a patient with glaucoma.
An ophthalmologist reports this combined service when removing a cataract, implanting an intraocular lens, and performing endoscopic cyclophotocoagulation (ECP) during the same operative session. ECP uses an endoscope to visualize and treat the ciliary processes; the combined approach is used for patients who have both a visually significant cataract and glaucoma. These procedures are typically performed in an ambulatory surgery center or hospital outpatient operating room.
The record should support the cataract extraction, lens implantation, and ECP, including the clinical indications and operative work performed. Choose this code when the cataract procedure includes ECP; use a cataract code without ECP when that treatment is not 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 one session, the highest-valued procedure is paid in full and others at 50%; bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 66991
- 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 RVU9.00 · 52%
- Practice expense (office) RVU7.74 · 44%
- Malpractice RVU0.69 · 4%
171.8K
Medicare services in 2024 · #414 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.
66991 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Use 66982 for complex cataract surgery without ECP. This code describes the combined cataract, lens implantation, and ECP service.
No office rate
66989 is the complex cataract counterpart with ECP; this code is used when the cataract procedure does not meet complex-service criteria.
Compare 66991 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
Iowa →
Office / nonfacility
Unavailable
Facility
$546.31
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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 66991 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
7,414
- Code
- 66991
- Physician work
- 9.00
- Practice expense
- 7.74
- Malpractice
- 0.69
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.00 | × 1.000 | 9.0000 |
| Practice expense | 7.74 | × 0.915 | 7.0821 |
| Malpractice | 0.69 | × 0.397 | 0.2739 |
| Total RVUs | 16.3560 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$546.31
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9 | 1 |
| Practice expense | 7.74 | 0.915 |
| Malpractice | 0.69 | 0.397 |
(9 × 1 + 7.74 × 0.915 + 0.69 × 0.397) × $33.4009 = $546.31
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.
66991 billing questions
How does this differ from routine cataract surgery with an intraocular lens?
This code includes ECP performed during the cataract and lens implantation session. A cataract code without ECP is used when ECP is not performed.
Does this code include the ECP treatment?
Yes. The code represents cataract extraction, lens implantation, and ECP performed together; document each part of the operative service.
When should the complex cataract variant be considered?
Use the complex variant when the operative circumstances meet the criteria for complex cataract surgery and ECP is also performed. Do not select it solely because the patient has glaucoma.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported under the CMS rules provided?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.
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.
7,41166988,,Xcapsl ctrc rmvl w/ecp,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.70,0.20,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41266989,,Xcpsl ctrc rmvl cplx insj 1+,A,,11.83,8.77,NA,8.77,,0.92,21.52,21.52,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41366990,,Ophthalmic endoscope add-on,A,,1.47,0.52,NA,0.52,,0.12,2.11,2.11,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41466991,,Xcapsl ctrc rmvl insj 1+,A,,9.00,7.74,NA,7.74,,0.69,17.43,17.43,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41566999,,Unlisted px ant segment eye,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41667005,,Partial removal of eye fluid,A,,5.74,6.19,NA,6.19,,0.45,12.38,12.38,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41767010,,Partial removal of eye fluid,A,,6.88,6.60,NA,6.60,,0.54,14.02,14.02,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136