Cataract Surgery CPT Codes
Cataract billing starts with the right code, and the right code comes from the operative note. The table below lists the codes we bill most often.
| Code | Description | Documentation needed |
|---|---|---|
| 66984 | Routine cataract removal with IOL | Standard phacoemulsification and lens placement |
| 66982 | Complex cataract removal with IOL | Named device or technique beyond a routine case |
| 66989 or 66991 | Cataract surgery with trabecular bypass stent (complex or routine) | Glaucoma diagnosis and device insertion, one unit per eye |
| 66987 or 66988 | Cataract surgery with endoscopic cyclophotocoagulation (complex or routine) | Glaucoma diagnosis and ECP performed |
| 92136 | Optical biometry | IOL power calculation, split professional and technical parts where billed |
Billing 66982 without a qualifying factor in the note is a known audit target. When the note does not support complex surgery, we bill 66984 and tell the surgeon what the note would need.
How Do You Bill Bilateral Cataract Surgery?
Most patients have both eyes done within weeks of each other, so the second surgery often falls inside the first eye's 90-day global period. We follow three rules on every bilateral case.
- One eye per line. Each surgery is billed on its own date with RT or LT. Medicare rejects modifier 50 on 66984.
- Modifier 79 for the second eye. Surgery on the other eye inside the first eye's global period is billed with 79, which starts a new global period.
- Visits in the global period. Routine post-op visits are not billed. An unrelated problem is billed with modifier 24, and the decision for the second eye's surgery can carry modifier 57 when it happens at a separate visit before a major procedure.
Premium IOL Billing for Cataract Patients
Presbyopia-correcting and astigmatism-correcting lenses let patients pay for extra benefits beyond standard cataract surgery. Medicare pays for the standard surgery. The patient pays the added cost of the premium lens and the added services tied to it, such as extra measurements and refractive follow-up. The same applies to femtosecond laser steps used for astigmatism correction.
We keep these charges off the insurance claim, set up a separate patient invoice and make sure the signed financial agreement is on file before surgery. The type of lens never changes the CPT code. Using 66982 because a premium lens was implanted is upcoding. Our patient billing team can set up deposits and payment plans for these upgrades.
Cataract Co-Management Billing With Optometrists
When an optometrist provides post-operative care, the claim is split. The surgeon bills 66984 with modifier 54 for surgical care only, and the optometrist bills 66984 with modifier 55 for post-operative care, using the date of surgery and the date care was transferred. Both sides need a written transfer of care, and the patient must agree to the arrangement. We bill both sides when we serve both practices, which keeps the dates consistent.
2026 Cataract Payment Changes
The 2026 Medicare national payment for 66984 is $462.94, down from $521.75 in 2025. The drop comes from the 2.5% efficiency adjustment on surgical work RVUs combined with practice expense changes. Commercial contracts tied to current Medicare rates fell with it. Our fee schedule review shows which of your contracts moved and by how much.
Cataract Billing for Surgeons and ASCs Across the USA
When the surgery happens in an ambulatory surgery center, the ASC bills its own facility claim, and an anesthesia claim may follow (00142 for lens surgery). We handle surgeon claims for practices across the USA and, where you own or manage the center, the facility claims through our ophthalmic ASC billing service. Start with a free billing audit of your recent surgical claims.