Home / Medicare fees / 66991

66991 Xcapsl ctrc rmvl insj 1+

What 66991 is

CMS fee schedule short descriptor: Xcapsl ctrc rmvl insj 1+.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 66991 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)9.007.740.6917.43$582.18
Facility (hospital, ASC)9.007.740.6917.43$582.18

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 66991 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 66991? These codes are bundled into it

66991 is a Column 1 code in 286 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
00142Anes px on eye lens surgery0 - no modifier bypassCheck pair
00144Anes px eye corneal trnspl0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0253TInsert aqueous drain device1 - modifier may bypassCheck pair
0308TInsj ocular telescope prosth1 - modifier may bypassCheck pair
0449TInsj aqueous drain dev 1st1 - modifier may bypassCheck pair
0450TInsj aqueous drain dev each1 - modifier may bypassCheck pair
0474TInsj aqueous drg dev io rsvr1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0671TInsj ant sgm aq drg dev 1+1 - modifier may bypassCheck pair
0699TNjx pst chmbr eye medication1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair

Showing 30 of 286 column 2 codes. Use the pair checker for any specific combination.

66991 is bundled into these codes

66991 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 66991 is the code that denies.

Column 1 codeShort descriptionModifier indicator
66170Glaucoma surgery1Check pair
66172Incision of eye1Check pair
66179Aqueous shunt eye w/o graft1Check pair
66180Aqueous shunt eye w/graft1Check pair
66183Insert ant drainage device1Check pair
66184Revision of aqueous shunt1Check pair
66185Revise aqueous shunt eye1Check pair
66761Revision of iris1Check pair
66850Removal of lens material1Check pair
66852Removal of lens material1Check pair
66930Extraction of lens1Check pair
66940Extraction of lens1Check pair
66982Xcapsl ctrc rmvl cplx wo ecp1Check pair
66985Insert lens prosthesis1Check pair
66987Xcapsl ctrc rmvl cplx w/ecp1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.