Billing code 66920: Lens extractionMedicare rate & RVUs in Washington
Reports surgical removal of the crystalline lens with its capsule when an intracapsular extraction is performed without the one-stage implant service.
CMS doesn’t publish an office rate for 66920 in Washington.
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 66920 covers
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.
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 66920 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $647.70 |
| Seattle (King Cnty) | Unavailable | $709.86 |
How the 66920 rate is calculated
Each of 66920’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 · 66920
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.88Practice expense 8.34Malpractice 0.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 66920
66920 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 66920
Lens extraction
| 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 · 66920
Lens extraction
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
66920 without 50 · national facility
$634.95
Lens extraction
66920-50 · Bilateral: 150%
$952.43
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).
66920 compared with similar codes
Compare codes
66920 vs 66930 vs 66940 vs 66983 vs 66984: national Medicare rates
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How to choose
- 66930Lens extraction
- Both are intracapsular lens-removal services. Choose 66930 when the documented procedure uses the aspiration technique specified for that code.
- 66940Lens extraction
- 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.
- 66983Cataract 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.
- 66984Cataract surgery
- 66984 combines an extracapsular cataract removal with intraocular lens insertion. It differs from 66920 in both the extraction approach and the included implant service.
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 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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