No office rate
Both are intracapsular lens-removal services. Choose 66930 when the documented procedure uses the aspiration technique specified for that code.
On this page
CMS RVU26D · Effective 2026-10-01
66920 Lens extraction Medicare reimbursement rates in Rhode Island
Reports surgical removal of the crystalline lens with its capsule when an intracapsular extraction is performed without the one-stage implant service. Compare 66920 office and facility rates across CMS payment localities in Rhode Island.
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 66920 in Rhode Island?
Rhode Island 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
$647.56
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 surgery
About 66920: Intracapsular lens extraction
Reports surgical removal of the crystalline lens with its capsule when an intracapsular extraction is performed without the one-stage implant service.
An ophthalmologist removes the crystalline lens together with its capsule using an intracapsular technique. This is a cataract operation, generally performed in an operating room or other surgical facility. The operative report should identify the extraction method and establish that the capsule was removed with the lens, rather than left in place as in an extracapsular approach. Code 66920 represents the extraction service, not the one-stage intracapsular extraction with lens implant described by code 66983.
Choose the code from the procedure actually performed, not simply the diagnosis of cataract. 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 procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 66920
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.88 · 52%
- Practice expense (office) RVU8.34 · 44%
- Malpractice RVU0.79 · 4%
80
Medicare services in 2024 · #5056 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.
66920 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
66940 is for an extracapsular approach, which leaves the capsule rather than removing it with the lens. Use 66920 when the operative report documents intracapsular removal.
66983
No office rateCataract surg w/iol 1 stage
66983 includes one-stage intracapsular cataract extraction with intraocular lens insertion. 66920 describes the intracapsular extraction service without that combined implant service.
No office rate
66984 combines an extracapsular cataract removal with intraocular lens insertion. It differs from 66920 in both the extraction approach and the included implant service.
Compare 66920 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$647.56
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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 66920 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,402
- Code
- 66920
- Physician work
- 9.88
- Practice expense
- 8.34
- Malpractice
- 0.79
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.88 | × 1.019 | 10.0677 |
| Practice expense | 8.34 | × 1.033 | 8.6152 |
| Malpractice | 0.79 | × 0.892 | 0.7047 |
| Total RVUs | 19.3876 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$647.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.88 | 1.019 |
| Practice expense | 8.34 | 1.033 |
| Malpractice | 0.79 | 0.892 |
(9.88 × 1.019 + 8.34 × 1.033 + 0.79 × 0.892) × $33.4009 = $647.56
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.
66920 billing questions
How does 66920 differ from 66940?
66920 describes an intracapsular approach, in which the lens and capsule are removed together. Use 66940 for an extracapsular extraction, where the capsule is not removed with the lens.
When is 66983 more appropriate?
66983 describes a one-stage intracapsular cataract extraction with insertion of an intraocular lens. When that implant is placed as part of the operation, report the code that includes the combined service rather than 66920 alone.
What documentation supports 66920?
The operative report should identify the intracapsular technique and document removal of the lens with its capsule. A cataract diagnosis by itself does not establish which extraction method was performed.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. These services are part of the surgical global period.
How is bilateral surgery reported and paid?
For bilateral surgery reported with modifier 50, CMS payment is at 150%. The CMS multiple-procedure reduction also applies when multiple procedures are performed in the same session.
When can an assistant or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; team surgery is 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.
7,39966840,,Removal of lens material,A,,8.95,8.02,NA,8.02,,0.71,17.68,17.68,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40066850,,Removal of lens material,A,,10.29,8.95,NA,8.95,,0.82,20.06,20.06,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40166852,,Removal of lens material,A,,11.12,9.25,NA,9.25,,0.89,21.26,21.26,0,090,0.10,0.70,0.20,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40266920,,Extraction of lens,A,,9.88,8.34,NA,8.34,,0.79,19.01,19.01,0,090,0.10,0.70,0.20,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40366930,,Extraction of lens,A,,11.32,9.51,NA,9.51,,0.91,21.74,21.74,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40466940,,Extraction of lens,A,,10.11,9.08,NA,9.08,,0.81,20.00,20.00,0,090,0.10,0.70,0.20,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40566982,,Xcapsl ctrc rmvl cplx wo ecp,A,,9.99,8.10,NA,8.10,,0.79,18.88,18.88,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537