What is the standard insurance baseline for CPT 66991?

The standard insurance baseline reimbursement rate is $726.00. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Extracapsular Removal of Cataract with Insertion of Artificial Lens and Insertion of Drainage Device in Front Chamber of Eye

CPT 66991Medical Service

Extracapsular Removal of Cataract with Insertion of Artificial Lens and Insertion of Drainage Device in Front Chamber of Eye

Q: What do doctors typically charge for Extracapsular Removal of Cataract with Insertion of Artificial Lens and Insertion of Drainage Device in Front Chamber of Eye?

The nationwide median physician charge for Extracapsular Removal of Cataract with Insertion of Artificial Lens and Insertion of Drainage Device in Front Chamber of Eye (CPT 66991) is $3945.69. Doctor billed charges vary based on geographic region, setting, and overhead.

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye. Clinical pricing breakdown and utilization metrics across 1,445 practicing doctors nationwide.

$3945.69

Peer Median Charge

Gross billed rate

$726.00

Standard Baseline

Customary allowable

5.4x

National Markup

Charge vs baseline

1,445

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $3945.69. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $726.00 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 66991 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"