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 in Alabama
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 in Alabama.
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 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$676.32
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
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 rates for Alabama, 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.
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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$676.32
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 66185 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
7,374
- Code
- 66185
- Physician work
- 10.32
- Practice expense
- 10.81
- Malpractice
- 0.83
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.32 | × 1.000 | 10.3200 |
| Practice expense | 10.81 | × 0.875 | 9.4588 |
| Malpractice | 0.83 | × 0.566 | 0.4698 |
| Total RVUs | 20.2485 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$676.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.32 | 1 |
| Practice expense | 10.81 | 0.875 |
| Malpractice | 0.83 | 0.566 |
(10.32 × 1 + 10.81 × 0.875 + 0.83 × 0.566) × $33.4009 = $676.32
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515