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See a sample rate comparisonCPT 66986 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Exchange Intraocular Lens
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 66986 |
| Medicaid Fee Schedule | View Medicaid rates for 66986 |
National average reimbursement for CPT 66986 by major payers:
$1,218.37
$1,166.27
$1,229.60
$1,450.17
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CPT 66986
5 of 25 sample ratesHigher to lower in this preview
Cody Good
$1,589.68Published rateWalter Mayo
Coastal Eye Group, PC
$1,035.58Published rateWeston Barney
Hoopes Vision Correction Center PC
$832.80Published rateJennifer Seibert
Clemson Eye, PA
$660.44Published rateBrenna Robertson
$539.21Published rate
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See a sample payer proposalCPT 66986 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66986 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 66986 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 66985-CPT | Moderate | Insertion Of Intraocular Lens, Insertion Of Intraocular Lens Prosthesis (Secondaryimplant) Not Associated With Concurrent Cataractremoval |
| 66986-CPT | High | Exchange Intraocular Lens |
| 66987-CPT | High | Xcapsl Ctrc Rmvl Cplx W Ecp, Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis 1 Stage Procedure Manual Or Mechanical Technique Eg Irrigation And Aspiration Or Phacoemulsification Complex Requiring Devices Or Techniques Not Generally Used In Routine Cataract Surgery Eg Iris Expansion Device Suture Support For Intraocular Lens Or Primary Posterior Capsulorrhexis Or Performed On Patients In The Amblyogenic Developmental Stage With Endoscopic Cyclophotocoagulation |
| 66988-CPT | High | Xcapsl Ctrc Rmvl W Ecp, Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis 1 Stage Procedure Manual Or Mechanical Technique Eg Irrigation And Aspiration Or Phacoemulsification With Endoscopic Cyclophotocoagulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66986. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66986 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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