How much does Medicare pay for CPT 66984?

Medicare allowed an average of $304.21 per service and paid $240.57 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1272.27, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 66984?

Removal of cataract with insertion of prosthetic lens. It was billed 6,680,450 times to 1,695,981 Medicare beneficiaries by 15,527 providers in 2024.

Does 66984 pay differently in an office than a hospital?

Yes. The allowed amount averaged $9.52 in an office setting and $649.92 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 66984 most?

Optometry, with 3,786,720 services from 5,144 clinicians. Next are Ophthalmology, Ambulatory Surgical Center, Osteopathic Manipulative Medicine.

CPT 66984

Removal of cataract with insertion of prosthetic lens

$304.21Medicare-allowed amount per service, averaged across 6,680,450 services

Providers submitted

$1272.27

Asking price, not received

Medicare allowed

$304.21

The fee schedule figure

Medicare paid

$240.57

Balance is patient coinsurance

Providers submitted an average of $1272.27 for this code and Medicare allowed $304.21 — 4.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $240.57 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $9.52
Hospital / facility: $649.92

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 3,606,312 services were billed in an office setting and 3,074,138 in a facility.

Services: 6,680,450
Beneficiaries: 1,695,981
Providers billing it: 15,527
Total allowed: $2,032,259,694

What Medicare pays for CPT 66984

Across 6,680,450 services billed by 15,527 providers to 1,695,981 beneficiaries, Medicare allowed an average of $304.21 per service. That is 3.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 66984

Specialty	Services	Beneficiaries	Avg allowed	Providers
Optometry	3,786,720	114,725	$4.60	5,144
Ophthalmology	1,736,368	879,989	$407.24	8,542
Ambulatory Surgical Center	1,156,933	701,007	$1130.19	1,835
Osteopathic Manipulative Medicine	220	118	$461.77	1
Internal Medicine	91	64	$545.87	2
Family Practice	74	42	$496.80	1
General Practice	44	36	$653.04	2

66984 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Illinois	663,582	$105.47	$83.59	552
North Carolina	577,498	$97.54	$81.41	576
Kentucky	456,780	$59.74	$50.79	292
Wisconsin	432,508	$61.08	$49.63	328
Ohio	393,545	$158.04	$133.27	502
Virginia	367,462	$184.33	$151.04	379
Tennessee	319,400	$168.81	$147.76	426
Minnesota	297,359	$74.56	$59.00	293
Georgia	243,849	$223.90	$183.75	383
California	228,267	$907.65	$610.34	1,250
Alabama	225,051	$101.45	$91.77	268
Florida	204,972	$731.88	$605.02	911
Texas	201,728	$724.03	$592.65	986
Massachusetts	200,738	$301.18	$227.84	316
South Carolina	180,105	$269.29	$227.82	246
New York	173,662	$520.96	$374.25	667
Maine	133,644	$51.63	$42.10	87
Pennsylvania	117,527	$679.58	$551.97	652
Indiana	81,919	$636.63	$526.00	443
Missouri	80,664	$484.96	$410.09	415
New Jersey	76,187	$895.64	$657.33	351
Arizona	73,853	$793.26	$641.90	260
Washington	73,628	$756.27	$575.52	437
Maryland	70,940	$811.50	$639.83	256
West Virginia	64,583	$99.93	$85.53	82
Michigan	62,978	$658.10	$547.30	445
Oklahoma	55,030	$589.79	$508.46	339
Iowa	51,149	$429.94	$365.82	321
Colorado	47,405	$747.08	$594.64	261
Kansas	45,915	$571.38	$487.22	301
Mississippi	41,243	$621.17	$565.13	226
Arkansas	37,893	$623.62	$547.88	218
Oregon	36,196	$771.09	$582.95	247
Louisiana	35,427	$649.00	$564.92	207
Rhode Island	33,268	$113.80	$89.32	41
Nebraska	32,759	$588.25	$492.69	193
New Hampshire	32,310	$390.03	$309.82	57
Connecticut	31,559	$514.01	$381.78	141
Nevada	25,055	$771.25	$607.10	118
Utah	22,589	$667.72	$551.33	152
South Dakota	22,109	$525.26	$445.92	121
Idaho	21,564	$678.74	$575.78	145
Montana	19,384	$659.00	$548.48	114
New Mexico	18,355	$702.66	$579.35	62
Delaware	15,506	$783.40	$619.03	59
North Dakota	13,813	$567.97	$474.53	101
Hawaii	9,487	$835.73	$612.76	68
Vermont	9,090	$379.81	$302.23	20
Alaska	7,230	$874.08	$610.45	56
Wyoming	7,121	$529.82	$435.84	78
District of Columbia	2,764	$563.95	$405.68	28
Puerto Rico	2,133	$636.52	$659.58	38
Guam	954	$852.59	$699.05	5
U.S. Virgin Islands	596	$732.33	$655.99	4
Northern Mariana Islands	57	$543.81	$401.82	1
AP	41	$99.41	$83.91	1

Related codes

66982Complex removal of cataract$728.10
66991Extracapsular removal of cataract$2193.25
66986Exchange of prosthetic lens$806.71
66988Removal of cataract$1349.13
66989Complex extracapsular removal of cataract$2460.11

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.