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Billing code 66500: Surgical iridotomyMedicare rate & RVUs

Report this service when an ophthalmic surgeon creates an iris opening by incision, such as to relieve pupillary block, without separately excising iris tissue.

CMS RVU26DEffective Oct 1, 2026109 payment localities101 Medicare services in 2024

Medicare pays $352.38 for 66500 nationally in a facility.

Medicare rate · 66500

Surgical iridotomy

Swap in your local Medicare rate.

Work RVUs
3.73
Total RVUs
10.55
Global days
090

National rate · 2026

$352.38

Facility setting, before claim adjustments.

See every locality for 66500 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 66500 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 66500 covers

An ophthalmic surgeon creates an opening in the iris through a surgical incision. A typical clinical use is a peripheral iridotomy to provide another route for aqueous flow in an eye with pupillary block, including angle-closure glaucoma. The procedure is performed in an operative setting; it is distinct from creating the opening with a laser and from removing a portion of iris tissue.

Report 66500 when the operative record supports an incision-created iris opening without iridectomy. Document the eye treated, indication, operative approach, and whether iris tissue was excised; use the code describing the additional tissue removal when applicable. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. For bilateral surgery with modifier 50, CMS 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 barred; co-surgeons require 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 66500 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

66500 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$320.91
Alaska*Unavailable$424.50
ArizonaUnavailable$344.22
ArkansasUnavailable$316.93
AtlantaUnavailable$358.19
AustinUnavailable$364.17
BakersfieldUnavailable$371.90
Baltimore/Surr. CntysUnavailable$372.59
BeaumontUnavailable$332.06
BrazoriaUnavailable$349.28

66500 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
66500 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 66500 rate is calculated

Each of 66500’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 · 66500

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.73Practice expense 6.53Malpractice 0.29

10.5500 adjusted RVUs×$33.4009 conversion factor=$352.38

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 66500

66500 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 66500

Surgical iridotomy

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 · 66500

Surgical iridotomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

66500 without 50 · national facility

$352.38

Surgical iridotomy

66500-50 · Bilateral: 150%

$528.57

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

66500 compared with similar codes

Compare codes

66500 vs 66505 vs 66761: national Medicare rates

Swap in your local Medicare rate.

  • 66500
    Surgical iridotomy · 3.73 wRVU
    —
  • 66505
    Iris surgery · 4.11 wRVU
    —
  • 66761
    Laser iridotomy · 2.93 wRVU
    $299.27

How to choose

66505Iris surgery
Choose 66500 for an incision-created iris opening without iridectomy; 66505 includes iridectomy.
66761Laser iridotomy
66761 is the laser procedure. Use 66500 when the iris opening is created with a surgical incision.

Codes related to 66500

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

Codes related to 66500
CodeHow it relatesNational office range
Same family
66505Iris surgeryIncision-based iridotomy that includes iridectomy.No office rate
Used instead
66761Laser iridotomyLaser approach for an iris opening or iridectomy.$268.35–$392.40

66500 billing questions

How does 66500 differ from 66505?

66500 describes an incision-created iris opening without iridectomy. Use 66505 when the incision-based procedure also includes iridectomy.

When is 66761 used instead?

66761 describes an iris opening or iridectomy performed by laser. Code 66500 is for an opening created by surgical incision.

Are related postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.

How is bilateral surgery reported?

For bilateral performance, report modifier 50; CMS payment is 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is barred for this code. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

What documentation supports choosing 66500?

Record the indication, treated eye, surgical approach, and that an iris opening was created by incision. Document whether iris tissue was also excised to distinguish the service from 66505.

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 66500PPRRVU2026_Oct_nonQPP.csv, line 7,377 (RVU26D)

Open CMS sourceHow we calculate rates

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