No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
66185 Shunt revision Medicare reimbursement rates
Revision of an existing glaucoma aqueous shunt that includes graft placement, such as patching exposed tubing to protect the implant. Compare 66185 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 66185?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$669.13–$918.13
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $249.00 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 66185 pays more and less
Ophthalmology surgery
About 66185: Aqueous shunt revision with graft
Revision of an existing glaucoma aqueous shunt that includes graft placement, such as patching exposed tubing to protect the implant.
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.
CMS billing rules for 66185
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.32 · 47%
- Practice expense (office) RVU10.81 · 49%
- Malpractice RVU0.83 · 4%
2.3K
Medicare services in 2024 · #2365 by national volume
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.
66185 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
66180 describes initial placement of an aqueous shunt with graft. Use 66185 when revising an existing shunt and placing a graft.
No office rate
66179 describes initial aqueous shunt placement without graft; 66185 is for graft-involving revision of an existing shunt.
No office rate
66183 is insertion of an anterior-segment drainage device without an extraocular reservoir. It is not revision of an existing reservoir shunt.
See how rates vary across the country
66185 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 66185 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $676.32 |
| Alaska* | Office Unavailable | Facility $916.85 |
| Arizona | Office Unavailable | Facility $718.30 |
| Arkansas | Office Unavailable | Facility $669.13 |
| Atlanta | Office Unavailable | Facility $745.87 |
| Austin | Office Unavailable | Facility $751.95 |
| Bakersfield | Office Unavailable | Facility $763.86 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $771.93 |
| Beaumont | Office Unavailable | Facility $699.02 |
| Brazoria | Office Unavailable | Facility $726.89 |
| Chicago | Office Unavailable | Facility $773.60 |
| Chico | Office Unavailable | Facility $761.14 |
| Colorado | Office Unavailable | Facility $754.66 |
| Connecticut | Office Unavailable | Facility $774.00 |
| Dallas | Office Unavailable | Facility $731.21 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $819.50 |
| Delaware | Office Unavailable | Facility $728.07 |
| Detroit | Office Unavailable | Facility $739.86 |
| East St. Louis | Office Unavailable | Facility $732.71 |
| El Centro | Office Unavailable | Facility $761.28 |
| Fort Lauderdale | Office Unavailable | Facility $760.58 |
| Fort Worth | Office Unavailable | Facility $727.95 |
| Fresno | Office Unavailable | Facility $761.14 |
| Galveston | Office Unavailable | Facility $728.95 |
| Hanford-Corcoran | Office Unavailable | Facility $761.14 |
| Hawaii, Guam | Office Unavailable | Facility $771.28 |
| Houston | Office Unavailable | Facility $744.14 |
| Idaho | Office Unavailable | Facility $689.99 |
| Indiana | Office Unavailable | Facility $692.88 |
| Iowa | Office Unavailable | Facility $686.08 |
| Kansas | Office Unavailable | Facility $685.07 |
| Kentucky | Office Unavailable | Facility $691.05 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $804.38 |
| Madera | Office Unavailable | Facility $761.14 |
| Manhattan | Office Unavailable | Facility $830.28 |
| Merced | Office Unavailable | Facility $761.14 |
| Metropolitan Boston | Office Unavailable | Facility $814.61 |
| Metropolitan Kansas City | Office Unavailable | Facility $710.82 |
| Metropolitan Philadelphia | Office Unavailable | Facility $759.84 |
| Metropolitan St. Louis | Office Unavailable | Facility $716.21 |
| Miami | Office Unavailable | Facility $790.68 |
| Minnesota | Office Unavailable | Facility $724.44 |
| Mississippi | Office Unavailable | Facility $676.06 |
| Modesto | Office Unavailable | Facility $761.14 |
| Montana** | Office Unavailable | Facility $733.43 |
| Napa | Office Unavailable | Facility $856.38 |
| Nebraska | Office Unavailable | Facility $688.44 |
| Nevada** | Office Unavailable | Facility $729.22 |
| New Hampshire | Office Unavailable | Facility $744.82 |
| New Mexico | Office Unavailable | Facility $709.09 |
| New Orleans | Office Unavailable | Facility $715.95 |
| North Carolina | Office Unavailable | Facility $699.28 |
| North Dakota** | Office Unavailable | Facility $717.02 |
| Northern Nj | Office Unavailable | Facility $814.86 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $847.54 |
| Ohio | Office Unavailable | Facility $702.29 |
| Oklahoma | Office Unavailable | Facility $688.67 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $798.40 |
| Portland | Office Unavailable | Facility $771.98 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $789.12 |
| Puerto Rico | Office Unavailable | Facility $737.04 |
| Queens | Office Unavailable | Facility $833.51 |
| Redding | Office Unavailable | Facility $761.14 |
| Rest Of California | Office Unavailable | Facility $761.14 |
| Rest Of Florida | Office Unavailable | Facility $731.54 |
| Rest Of Georgia | Office Unavailable | Facility $699.81 |
| Rest Of Illinois | Office Unavailable | Facility $717.68 |
| Rest Of Louisiana | Office Unavailable | Facility $690.80 |
| Rest Of Maine | Office Unavailable | Facility $694.12 |
| Rest Of Maryland | Office Unavailable | Facility $738.99 |
| Rest Of Massachusetts | Office Unavailable | Facility $752.51 |
| Rest Of Michigan | Office Unavailable | Facility $705.65 |
| Rest Of Missouri | Office Unavailable | Facility $682.94 |
| Rest Of New Jersey | Office Unavailable | Facility $783.18 |
| Rest Of New York | Office Unavailable | Facility $707.20 |
| Rest Of Oregon | Office Unavailable | Facility $723.81 |
| Rest Of Pennsylvania | Office Unavailable | Facility $702.35 |
| Rest Of Texas | Office Unavailable | Facility $712.38 |
| Rest Of Washington | Office Unavailable | Facility $750.48 |
| Rhode Island | Office Unavailable | Facility $748.95 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $770.28 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $791.88 |
| Salinas | Office Unavailable | Facility $788.72 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $801.90 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $899.27 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $898.33 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $918.13 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $914.27 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $776.67 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $805.49 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $790.21 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $813.28 |
| Seattle (King Cnty) | Office Unavailable | Facility $827.61 |
| South Carolina | Office Unavailable | Facility $701.88 |
| South Dakota** | Office Unavailable | Facility $715.08 |
| Southern Maine | Office Unavailable | Facility $720.00 |
| Stockton | Office Unavailable | Facility $761.14 |
| Suburban Chicago | Office Unavailable | Facility $767.05 |
| Tennessee | Office Unavailable | Facility $687.79 |
| Utah | Office Unavailable | Facility $708.99 |
| Vallejo | Office Unavailable | Facility $855.02 |
| Vermont | Office Unavailable | Facility $716.18 |
| Virgin Islands | Office Unavailable | Facility $737.04 |
| Virginia | Office Unavailable | Facility $719.20 |
| Visalia | Office Unavailable | Facility $761.14 |
| West Virginia | Office Unavailable | Facility $698.13 |
| Wisconsin | Office Unavailable | Facility $699.13 |
| Wyoming** | Office Unavailable | Facility $726.28 |
| Yuba City | Office Unavailable | Facility $761.14 |
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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 under the CMS facts?
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,37166180,,Aqueous shunt eye w/graft,A,,14.63,13.26,NA,13.26,,1.17,29.06,29.06,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,37266183,,Insert ant drainage device,A,,12.87,12.48,NA,12.48,,1.04,26.39,26.39,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,37366184,,Revision of aqueous shunt,A,,9.34,10.47,NA,10.47,,0.75,20.56,20.56,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,37466185,,Revise aqueous shunt eye,A,,10.32,10.81,NA,10.81,,0.83,21.96,21.96,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,37566225,,Repair/graft eye lesion,A,,12.31,10.44,NA,10.44,,1.00,23.75,23.75,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,37666250,,Follow-up surgery of eye,A,,6.92,15.03,,6.84,,0.55,22.50,14.31,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,37766500,,Incision of iris,A,,3.73,6.53,NA,6.53,,0.29,10.55,10.55,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00