CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 66985 RVU and Medicare Payment (2026)
Insert lens prosthesis — 9.73 work RVU, about $658.67 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.73
- PE RVU (non-facility)
- 9.2
- PE RVU (facility)
- 9.2
- MP RVU
- 0.79
- Office payment
- $658.67
- Facility payment
- $658.67
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 66985 in a non-facility setting with national GPCI: (9.73 + 9.2 + 0.79) × $33.4009 ≈ $658.67. The same code in a facility setting pays about $658.67 because facility PE RVU (9.2) replaces office PE RVU.
What changes by locality
GPCI moves 66985 non-facility payment from $602.54 to $829.29 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 66985?
9.73. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 66985 in 2026?
About $658.67 non-facility ($658.67 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (9.73) and malpractice RVU stay fixed; only practice expense changes (9.2 office vs 9.2 facility). That is the entire office-vs-facility payment gap.