CPT code 66185: Shunt revision, with graft2026 Medicare rate & RVUs in Montana
Revision of an existing glaucoma aqueous shunt that includes graft placement, such as patching exposed tubing to protect the implant.
In Montana, Medicare pays $733.43 for 66185 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 66185 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Montana compares for 66185
Across 109 of 109 payment localities, the facility rate for 66185 runs from $669.13 in Arkansas to $918.13 in San Benito County, CA. Montana pays $733.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$733.43
- Los Angeles, CA · California$804.38+$70.95
- Washington, DC area · District of Columbia$819.50+$86.07
- Miami, FL · Florida$790.68+$57.25
- Chicago, IL · Illinois$773.60+$40.17
- Manhattan, NY · New York$830.28+$96.85
- Alaska · Alaska$916.85+$183.42
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $676.32 |
| ArkansasArkansas | — | $669.13 |
| ArizonaArizona | — | $718.30 |
| Bakersfield, CACalifornia | — | $763.86 |
| Chico, CACalifornia | — | $761.14 |
| El Centro, CACalifornia | — | $761.28 |
| Fresno, CACalifornia | — | $761.14 |
| Hanford, CACalifornia | — | $761.14 |
| Madera, CACalifornia | — | $761.14 |
| Merced, CACalifornia | — | $761.14 |
| Modesto, CACalifornia | — | $761.14 |
| Napa, CACalifornia | — | $856.38 |
| Oxnard, CACalifornia | — | $798.40 |
| Redding, CACalifornia | — | $761.14 |
| Rest of CaliforniaCalifornia | — | $761.14 |
| Riverside, CACalifornia | — | $770.28 |
| Sacramento, CACalifornia | — | $791.88 |
| Salinas, CACalifornia | — | $788.72 |
| San Diego, CACalifornia | — | $801.90 |
| Marin County, CACalifornia | — | $899.27 |
| San Francisco, CACalifornia | — | $898.33 |
| San Benito County, CACalifornia | — | $918.13 |
| Santa Clara County, CACalifornia | — | $914.27 |
| San Luis Obispo, CACalifornia | — | $776.67 |
| Santa Cruz, CACalifornia | — | $805.49 |
| Santa Maria, CACalifornia | — | $790.21 |
| Santa Rosa, CACalifornia | — | $813.28 |
| Stockton, CACalifornia | — | $761.14 |
| Vallejo, CACalifornia | — | $855.02 |
| Visalia, CACalifornia | — | $761.14 |
| Yuba City, CACalifornia | — | $761.14 |
| ColoradoColorado | — | $754.66 |
| ConnecticutConnecticut | — | $774.00 |
| DelawareDelaware | — | $728.07 |
| Fort Lauderdale, FLFlorida | — | $760.58 |
| Rest of FloridaFlorida | — | $731.54 |
| Atlanta, GAGeorgia | — | $745.87 |
| Rest of GeorgiaGeorgia | — | $699.81 |
| Hawaii, Guam, HIHawaii | — | $771.28 |
| IowaIowa | — | $686.08 |
| IdahoIdaho | — | $689.99 |
| East St. Louis, ILIllinois | — | $732.71 |
| Rest of IllinoisIllinois | — | $717.68 |
| Suburban Chicago, ILIllinois | — | $767.05 |
| IndianaIndiana | — | $692.88 |
| KansasKansas | — | $685.07 |
| KentuckyKentucky | — | $691.05 |
| New Orleans, LALouisiana | — | $715.95 |
| Rest of LouisianaLouisiana | — | $690.80 |
| Metropolitan Boston, MAMassachusetts | — | $814.61 |
| Rest of MassachusettsMassachusetts | — | $752.51 |
| Baltimore area, MDMaryland | — | $771.93 |
| Rest of MarylandMaryland | — | $738.99 |
| Rest of MaineMaine | — | $694.12 |
| Southern Maine, MEMaine | — | $720.00 |
| Detroit, MIMichigan | — | $739.86 |
| Rest of MichiganMichigan | — | $705.65 |
| MinnesotaMinnesota | — | $724.44 |
| Metropolitan Kansas City, MOMissouri | — | $710.82 |
| Metropolitan St. Louis, MOMissouri | — | $716.21 |
| Rest of MissouriMissouri | — | $682.94 |
| MississippiMississippi | — | $676.06 |
| North CarolinaNorth Carolina | — | $699.28 |
| North DakotaNorth Dakota | — | $717.02 |
| NebraskaNebraska | — | $688.44 |
| New HampshireNew Hampshire | — | $744.82 |
| Northern New JerseyNew Jersey | — | $814.86 |
| Rest of New JerseyNew Jersey | — | $783.18 |
| New MexicoNew Mexico | — | $709.09 |
| NevadaNevada | — | $729.22 |
| NYC suburbs and Long Island, NYNew York | — | $847.54 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $789.12 |
| Queens, NYNew York | — | $833.51 |
| Rest of New YorkNew York | — | $707.20 |
| OhioOhio | — | $702.29 |
| OklahomaOklahoma | — | $688.67 |
| Portland, OROregon | — | $771.98 |
| Rest of OregonOregon | — | $723.81 |
| Metropolitan Philadelphia, PAPennsylvania | — | $759.84 |
| Rest of PennsylvaniaPennsylvania | — | $702.35 |
| Puerto RicoPuerto Rico | — | $737.04 |
| Rhode IslandRhode Island | — | $748.95 |
| South CarolinaSouth Carolina | — | $701.88 |
| South DakotaSouth Dakota | — | $715.08 |
| TennesseeTennessee | — | $687.79 |
| Austin, TXTexas | — | $751.95 |
| Beaumont, TXTexas | — | $699.02 |
| Brazoria, TXTexas | — | $726.89 |
| Dallas, TXTexas | — | $731.21 |
| Fort Worth, TXTexas | — | $727.95 |
| Galveston, TXTexas | — | $728.95 |
| Houston, TXTexas | — | $744.14 |
| Rest of TexasTexas | — | $712.38 |
| UtahUtah | — | $708.99 |
| VirginiaVirginia | — | $719.20 |
| Virgin Islands, VIUnited States Virgin Islands | — | $737.04 |
| VermontVermont | — | $716.18 |
| Rest of WashingtonWashington | — | $750.48 |
| King County, WAWashington | — | $827.61 |
| WisconsinWisconsin | — | $699.13 |
| West VirginiaWest Virginia | — | $698.13 |
| WyomingWyoming | — | $726.28 |
66185 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,374
- Code
- 66185
- Physician work
- 10.32
- Practice expense
- 10.81
- Malpractice
- 0.83
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.32 | × 1.000 | 10.3200 |
| Practice expense | 10.81 | × 1.000 | 10.8100 |
| Malpractice | 0.83 | × 0.998 | 0.8283 |
| Total RVUs | 21.9583 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$733.43
Facility: (10.32 × 1 + 10.81 × 1 + 0.83 × 0.998) × $33.4009 = $733.43
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share 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.
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).
How 66185 has changed in Montana
66185 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $733.43 | RVU26D |
| 2026-07-01 | Not available in this setting | $733.43 | RVU26C |
| 2026-04-01 | Not available in this setting | $733.43 | RVU26B |
| 2026-01-01 | Not available in this setting | $733.43 | RVU26A |
| 2025-10-01 | Not available in this setting | $815.84 | RVU25D |
| 2025-07-01 | Not available in this setting | $815.84 | RVU25C |
| 2025-04-01 | Not available in this setting | $815.84 | RVU25B |
| 2025-01-01 | Not available in this setting | $815.84 | RVU25A |
| 2024-10-01 | Not available in this setting | $841.90 | RVU24D |
| 2024-07-01 | Not available in this setting | $841.90 | RVU24C |
| 2024-04-01 | Not available in this setting | $841.90 | RVU24B |
| 2024-03-09 | Not available in this setting | $841.90 | RVU24AR |
| 2024-01-01 | Not available in this setting | $828.16 | RVU24A |
| 2023-10-01 | Not available in this setting | $848.26 | RVU23D |
| 2023-07-01 | Not available in this setting | $848.26 | RVU23C |
| 2023-04-01 | Not available in this setting | $848.26 | RVU23B |
| 2023-01-01 | Not available in this setting | $848.26 | RVU23A |
| 2022-10-01 | Not available in this setting | $852.38 | RVU22D |
| 2022-07-01 | Not available in this setting | $852.38 | RVU22C |
| 2022-04-01 | Not available in this setting | $852.38 | RVU22B |
| 2022-01-01 | Not available in this setting | $852.38 | RVU22A |
| 2021-10-01 | Not available in this setting | $854.95 | RVU21D |
| 2021-07-01 | Not available in this setting | $854.95 | RVU21C |
| 2021-04-01 | Not available in this setting | $854.95 | RVU21B |
| 2021-01-01 | Not available in this setting | $854.95 | RVU21A |
| 2020-10-01 | Not available in this setting | $873.37 | RVU20D |
| 2020-07-01 | Not available in this setting | $873.37 | RVU20C |
| 2020-04-01 | Not available in this setting | $873.37 | RVU20B |
| 2020-01-01 | Not available in this setting | $873.37 | RVU20A |
| 2019-10-01 | Not available in this setting | $884.02 | RVU19D |
| 2019-07-01 | Not available in this setting | $884.02 | RVU19C |
| 2019-04-01 | Not available in this setting | $884.02 | RVU19B |
| 2019-01-01 | Not available in this setting | $884.02 | RVU19A |
| 2018-10-01 | Not available in this setting | $883.77 | RVU18D |
| 2018-07-01 | Not available in this setting | $883.77 | RVU18C |
| 2018-04-01 | Not available in this setting | $883.77 | RVU18B |
| 2018-01-01 | Not available in this setting | $883.77 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $870.16 | RVU17D |
| 2017-07-01 | Not available in this setting | $870.16 | RVU17C |
| 2017-04-01 | Not available in this setting | $870.16 | RVU17B |
| 2017-01-01 | Not available in this setting | $870.16 | RVU17A |
| 2016-10-01 | Not available in this setting | $863.03 | RVU16D |
| 2016-07-01 | Not available in this setting | $863.03 | RVU16C |
| 2016-04-01 | Not available in this setting | $863.03 | RVU16B |
| 2016-01-01 | Not available in this setting | $863.03 | RVU16A |
| 2015-10-01 | Not available in this setting | $864.70 | RVU15D |
| 2015-07-01 | Not available in this setting | $864.70 | RVU15C |
| 2015-04-01 | Not available in this setting | $860.40 | RVU15B |
| 2015-01-01 | Not available in this setting | $860.40 | RVU15A |
| 2014-10-01 | Not available in this setting | $802.93 | RVU14D |
| 2014-07-01 | Not available in this setting | $802.93 | RVU14C |
| 2014-04-01 | Not available in this setting | $802.93 | RVU14B |
| 2014-01-01 | Not available in this setting | $802.93 | RVU14A |
| 2013-10-01 | Not available in this setting | $794.51 | RVU13D |
| 2013-07-01 | Not available in this setting | $794.51 | RVU13C |
| 2013-04-01 | Not available in this setting | $794.51 | RVU13B |
| 2013-01-01 | Not available in this setting | $794.51 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
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
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