CPT code 66160: Glaucoma surgery, iridencleisis technique2026 Medicare rate & RVUs in California

Reports glaucoma filtration surgery using iridencleisis, in which iris tissue is secured at a scleral fistula to provide an aqueous drainage pathway.

CMS RVU26DEffective Oct 1, 202629 payment localities28 Medicare services in 2024

CMS doesn’t publish an office rate for 66160 in California.

—Office (non-facility)
$879.62–$1,059.76Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 66160 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 66160 covers

In iridencleisis, the ophthalmic surgeon creates a fistula through the sclera and secures a portion of the iris in the opening to maintain aqueous outflow and reduce intraocular pressure. It is a filtration operation for glaucoma, rather than laser treatment or placement of an aqueous shunt. The procedure is generally performed in an operating room, commonly in a facility setting, by an ophthalmologist experienced in glaucoma surgery.

Report 66160 when the operative technique is iridencleisis; select a different glaucoma procedure code when the surgeon performs another filtration method, such as trabeculectomy or shunt implantation. The operative report should establish the glaucoma indication and describe the fistula and iris manipulation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, payment is 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 66160 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

66160 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CAUnavailable$882.82
Chico, CAUnavailable$879.62
El Centro, CAUnavailable$879.79
Fresno, CAUnavailable$879.62
Hanford, CAUnavailable$879.62
Los Angeles, CAUnavailable$929.35
Madera, CAUnavailable$879.62
Marin County, CAUnavailable$1,037.99
Merced, CAUnavailable$879.62
Modesto, CAUnavailable$879.62

How the 66160 rate is calculated

Each of 66160’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 66160

RVUs × geographic indexes × conversion factor

Office or facility?

Work12.08

12.08 RVUs× 1.000 GPCI

Practice expense12.34

12.34 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

25.4000

Conversion factor

$33.4009

Medicare rate

$848.38

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 66160

66160 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66160

Glaucoma surgery, iridencleisis technique

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 66160

Glaucoma surgery, iridencleisis technique

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

66160 without 50 · national facility

$848.38

Glaucoma surgery, iridencleisis technique

66160-50 · Bilateral: 150%

$1,272.57

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

66160 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 66160

    Glaucoma surgery, iridencleisis technique12.08 wRVU

    Not priced

  • 66170

    Trabeculectomy, without prior scarring13.59 wRVU

    Not priced

  • 66172

    Glaucoma surgery, prior surgery or trauma scarring14.47 wRVU

    Not priced

  • 66180

    Glaucoma shunt, with graft14.63 wRVU

    Not priced

How to choose

66170TrabeculectomyWithout prior scarring
66170 describes trabeculectomy, a filtration procedure performed by a different technique. Choose 66160 for iridencleisis, where iris tissue is secured in the scleral fistula.
66172Glaucoma surgeryPrior surgery or trauma scarring
66172 describes trabeculectomy in the setting of scarring from prior ocular surgery or trauma. It is not the code for iridencleisis.
66180Glaucoma shuntWith graft
66180 describes glaucoma drainage using an aqueous shunt. 66160 is selected when the surgeon creates a fistula and secures iris tissue in it.

66160 billing questions

How is 66160 distinguished from trabeculectomy codes?

Use 66160 when the surgeon performs iridencleisis, securing iris tissue in a scleral fistula. Trabeculectomy codes describe a different filtration technique.

Does the 90-day global period include postoperative visits?

Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral 66160 paid when modifier 50 is reported?

CMS pays a bilateral procedure reported with modifier 50 at 150%.

Can an assistant surgeon be paid for 66160?

Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What happens when 66160 is performed with another procedure in the same session?

The highest-valued procedure is paid in full, and the other procedure or procedures are paid at 50% under the standard multiple procedure reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 66160PPRRVU2026_Oct_nonQPP.csv, line 7,365 (RVU26D)

Open CMS sourceHow we calculate rates

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