Reimbursement
$462.94
Threshold
N/A
2026 Status
Active
What is CPT Code 66984?
CPT 66984 is defined as: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification). This is a comprehensive code for common cataract surgery.
This code is primarily used for Specialist services. It falls under the category of Ophthalmology / Surgery and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
7.17
Physician Effort
PE (Non-Fac)
6.16
Practice Expense
Malpractice
Risk Factor
Total RVU
13.86
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency adjustment
The -2.5% productivity adjustment reduces work RVU from 7.35 to 7.17, reflecting technological improvements in phacoemulsification.
pe facility cut
Indirect Practice Expense (PE) RVU allocation for ASCs and HOPDs is reduced by 50% for facility-based services.
total financial impact
Aggregate policies result in a stark 11% decrease in total allowable reimbursement vs 2025.
professional fee pressure
Devaluation of the global fee impacts both the surgeon and co-managing providers (Optometrists) proportionally.
Administrative Framework
Global Period
090
Place of Service
NCCI Exclusions
Key Modifiers
Operational Requirements
minimum time
Procedure-based
staff type
Ophthalmologist
frequency
Once per eye.
add on codes
global period inclusion
The payment is 'global', covering the pre-op, intra-op, and 90 days of normal post-op visits (99024).
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Cataract surgery remains a primary target for budget neutrality adjustments due to high volume.
Common Clinical Scenarios
CMS Eligibility: 1 (Cataract causing functional impairment). Permanent.
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Billing Differentiation
VS 66982_Complex
66982 is for 'Complex' cases (e.g., iris expansion, small pupil, prior trauma). 66984 is the 'Standard' code.
Frequently Asked Questions
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