No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
66985 Lens implantation Medicare reimbursement rates in Utah
Reports placement of an intraocular lens in an aphakic eye after the natural lens was removed in an earlier procedure. Compare 66985 office and facility rates across CMS payment localities in Utah.
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 66985 in Utah?
Utah 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
$637.54
1 of 1 localities have a supported rate.
Payment area: Utah
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 66985: Secondary intraocular lens implantation
Reports placement of an intraocular lens in an aphakic eye after the natural lens was removed in an earlier procedure.
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.
CMS billing rules for 66985
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.73 · 49%
- Practice expense (office) RVU9.20 · 47%
- Malpractice RVU0.79 · 4%
5.4K
Medicare services in 2024 · #1820 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.
66985 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
66986 describes exchange of an existing intraocular lens. 66985 describes secondary implantation when an intraocular lens is absent.
No office rate
66982 is for complex cataract removal with lens implantation in the same operation; 66985 is for a later implant procedure.
Compare 66985 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
Utah →
Office / nonfacility
Unavailable
Facility
$637.54
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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 66985 in Utah.
PPRRVU2026_Oct_nonQPP.csv
7,408
- Code
- 66985
- Physician work
- 9.73
- Practice expense
- 9.20
- Malpractice
- 0.79
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.73 | × 1.000 | 9.7300 |
| Practice expense | 9.20 | × 0.940 | 8.6480 |
| Malpractice | 0.79 | × 0.898 | 0.7094 |
| Total RVUs | 19.0874 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$637.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.73 | 1 |
| Practice expense | 9.2 | 0.94 |
| Malpractice | 0.79 | 0.898 |
(9.73 × 1 + 9.2 × 0.94 + 0.79 × 0.898) × $33.4009 = $637.54
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.
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 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.
7,40566982,,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
7,40666983,,Cataract surg w/iol 1 stage,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40766984,,Xcapsl ctrc rmvl w/o ecp,A,,7.17,6.14,NA,6.14,,0.54,13.85,13.85,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40866985,,Insert lens prosthesis,A,,9.73,9.20,NA,9.20,,0.79,19.72,19.72,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,40966986,,Exchange lens prosthesis,A,,11.95,9.98,NA,9.98,,0.95,22.88,22.88,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,41066987,,Xcapsl ctrc rmvl cplx 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
7,41166988,,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
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985