Billing code 66990: Ophthalmic endoscopyMedicare rate & RVUs in Washington
Reports use of an ophthalmic endoscope as an adjunct to a primary eye procedure, such as when endoscopic visualization or treatment is performed.
CMS doesn’t publish an office rate for 66990 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 66990 covers
This add-on identifies use of an ophthalmic endoscope during another eye operation, such as to visualize or deliver treatment to structures that are difficult to see directly. Ophthalmic surgeons may use it for endoscopic photocoagulation or other endoscope-assisted work during procedures involving the anterior segment or ciliary body. It describes the endoscope use, not the primary operation itself.
Report 66990 only with a qualifying primary procedure; it is not a standalone service. The operative report should identify the primary procedure and explain the endoscope’s use and the tissue or treatment target. CMS treats payment for this add-on as within the primary procedure’s global period. Do not use it to separately represent work already included in the primary procedure’s description.
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 66990 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $71.08 |
| Seattle (King Cnty) | Unavailable | $76.14 |
How the 66990 rate is calculated
Each of 66990’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 · 66990
RVUs × geographic indexes × conversion factor
Work1.47
1.47 RVUs× 1.000 GPCI
Practice expense0.52
0.52 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
2.1100
Conversion factor
$33.4009
Medicare rate
$70.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 66990
The CMS indicators that decide how 66990 is paid alongside other services.
CMS payment indicators · 66990
Ophthalmic endoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
66990 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 66984Cataract surgery
- 66984 represents routine cataract surgery with lens implantation. 66990 is an add-on for qualifying ophthalmic endoscope use and cannot replace the cataract procedure code.
- 66982Cataract surgery
- 66982 represents complex cataract surgery with lens implantation. Use 66990 only when endoscope use is also documented as a separately reportable adjunct.
- 66988Xcapsl ctrc rmvl w/ecp
- 66988 describes cataract surgery with endoscopic cyclophotocoagulation. Distinguish that defined combined service from other primary procedures involving separately reportable endoscope use.
- 66987Xcapsl ctrc rmvl cplx w/ecp
- 66987 is the complex cataract-surgery counterpart to 66988, with endoscopic cyclophotocoagulation included in the combined service. It is not interchangeable with the endoscope-use add-on.
66990 billing questions
Can 66990 be billed by itself?
No. It is an add-on and must be reported with a primary procedure.
What should the operative note show?
Document the primary operation, that an ophthalmic endoscope was used, and its role in visualization or treatment.
Is 66990 the cataract procedure code?
No. A cataract procedure such as 66984 or 66982 represents the primary surgery; 66990 identifies qualifying endoscope use in addition to that procedure.
How does the global period affect payment?
CMS pays 66990 within the global period of the primary procedure with which it is reported.
Is endoscopic cyclophotocoagulation always reported with 66990?
No. Choose codes based on the actual procedure performed and the applicable code description; document whether endoscope use is separately represented by the primary procedure.
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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