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CPT code 66185: Shunt revision, with graft2026 Medicare rate & RVUs

Revision of an existing glaucoma aqueous shunt that includes graft placement, such as patching exposed tubing to protect the implant.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.3K Medicare services in 2024

Medicare pays $733.48 for 66185 nationally in a facility.

Medicare rate · 66185

Shunt revision, with graft

Office or facility?

Work RVUs
10.32
Total RVUs
21.96
Global days
090

National rate · 2026

$733.48

Facility setting, before claim adjustments.

See every locality for 66185 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 66185 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 66185 covers

An ophthalmic surgeon revises an existing aqueous shunt used to manage glaucoma and places a graft as part of the repair. A common clinical situation is coverage of exposed shunt tubing with a patch graft. The service is generally performed in an operating room when an implanted drainage device needs surgical correction and graft material is used.

Report this code when the operative documentation supports revision of an existing shunt and use of a graft; revision without a graft is reported with 66184. Document the affected eye, the reason for revision, the work performed on the shunt, and graft placement. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is paid at 150% for bilateral surgery. Assistant-at-surgery payment may be made; co-surgeons and team surgery are 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 66185 pays more and less

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

109 of 109 payment localities

66185 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$676.32
AlaskaUnavailable$916.85
ArizonaUnavailable$718.30
ArkansasUnavailable$669.13
Atlanta, GAUnavailable$745.87
Austin, TXUnavailable$751.95
Bakersfield, CAUnavailable$763.86
Baltimore area, MDUnavailable$771.93
Beaumont, TXUnavailable$699.02
Brazoria, TXUnavailable$726.89

66185 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
66185 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 66185 rate is calculated

Each of 66185’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 · 66185

RVUs × geographic indexes × conversion factor

Office or facility?

Work10.32

10.32 RVUs× 1.000 GPCI

Practice expense10.81

10.81 RVUs× 1.000 GPCI

Malpractice0.83

0.83 RVUs× 1.000 GPCI

Adjusted RVUs

21.9600

Conversion factor

$33.4009

Medicare rate

$733.48

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

Payment rules and modifiers for 66185

66185 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66185

Shunt revision, with graft

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)2Paid.
Co-surgeons (62)0Not permitted.
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 · 66185

Shunt revision, with graft

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

66185 without 50 · national facility

$733.48

Shunt revision, with graft

66185-50 · Bilateral: 150%

$1,100.22

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

66185 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 66185

    Shunt revision, with graft10.32 wRVU

    Not priced

  • 66184

    Shunt revision, without graft9.34 wRVU

    Not priced

  • 66180

    Glaucoma shunt, with graft14.63 wRVU

    Not priced

  • 66179

    Glaucoma shunt, without graft13.65 wRVU

    Not priced

  • 66183

    Drainage device, without extraocular reservoir12.87 wRVU

    Not priced

How to choose

66184Shunt revisionWithout graft
Both describe revision of an aqueous shunt to an extraocular reservoir. Choose 66185 when a graft is used and 66184 when the revision is without a graft.
66180Glaucoma shuntWith graft
66180 describes initial placement of an aqueous shunt with graft. Use 66185 when revising an existing shunt and placing a graft.
66179Glaucoma shuntWithout graft
66179 describes initial aqueous shunt placement without graft; 66185 is for graft-involving revision of an existing shunt.
66183Drainage deviceWithout extraocular reservoir
66183 is insertion of an anterior-segment drainage device without an extraocular reservoir. It is not revision of an existing reservoir shunt.

Codes related to 66185

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 66185
CodeHow it relatesNational office range
Same family
66184Shunt revision, without graftRevision of an aqueous shunt without graft; the key distinction is graft use.No office rate
66180Glaucoma shunt, with graftInitial aqueous shunt placement with graft, rather than revision of an existing shunt.No office rate
66179Glaucoma shunt, without graftInitial aqueous shunt placement without graft.No office rate
Used instead
66183Drainage device, without extraocular reservoirInsertion of an anterior-segment drainage device without an extraocular reservoir, not revision of a reservoir shunt.No office rate

66185 billing questions

How is 66185 different from 66184?

66185 is for aqueous shunt revision with graft placement. Use 66184 when the revision is performed without a graft.

Does this code describe initial shunt placement?

No. It describes revision of an existing aqueous shunt with a graft. Initial placement is a different service, such as the procedures represented by 66179 or 66180.

What documentation supports reporting 66185?

Document the existing shunt, the reason for revision, the work performed, and that graft material was placed. Include the eye treated.

How is bilateral revision reported?

For bilateral surgery, modifier 50 is paid at 150% under the CMS rule for this code.

What is included in the global period?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.

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 66185PPRRVU2026_Oct_nonQPP.csv, line 7,374 (RVU26D)

Open CMS sourceHow we calculate rates

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