No office rate
66170 describes trabeculectomy, a filtration procedure performed by a different technique. Choose 66160 for iridencleisis, where iris tissue is secured in the scleral fistula.
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CMS RVU26D · Effective 2026-10-01
66160 Glaucoma surgery Medicare reimbursement rates in Iowa
Reports glaucoma filtration surgery using iridencleisis, in which iris tissue is secured at a scleral fistula to provide an aqueous drainage pathway. Compare 66160 office and facility rates across CMS payment localities in Iowa.
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 66160 in Iowa?
Iowa 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
$793.61
1 of 1 localities have a supported rate.
Payment area: Iowa
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 66160: Glaucoma fistula with iridencleisis
Reports glaucoma filtration surgery using iridencleisis, in which iris tissue is secured at a scleral fistula to provide an aqueous drainage pathway.
In iridencleisis, the ophthalmic surgeon creates a fistula through the sclera and secures a portion of the iris in the opening to maintain aqueous outflow and reduce intraocular pressure. It is a filtration operation for glaucoma, rather than laser treatment or placement of an aqueous shunt. The procedure is generally performed in an operating room, commonly in a facility setting, by an ophthalmologist experienced in glaucoma surgery.
Report 66160 when the operative technique is iridencleisis; select a different glaucoma procedure code when the surgeon performs another filtration method, such as trabeculectomy or shunt implantation. The operative report should establish the glaucoma indication and describe the fistula and iris manipulation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, 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 restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 66160
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.08 · 48%
- Practice expense (office) RVU12.34 · 49%
- Malpractice RVU0.98 · 4%
28
Medicare services in 2024 · #5717 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.
66160 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
66172 describes trabeculectomy in the setting of scarring from prior ocular surgery or trauma. It is not the code for iridencleisis.
No office rate
66180 describes glaucoma drainage using an aqueous shunt. 66160 is selected when the surgeon creates a fistula and secures iris tissue in it.
Compare 66160 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
Iowa →
Office / nonfacility
Unavailable
Facility
$793.61
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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 66160 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
7,365
- Code
- 66160
- Physician work
- 12.08
- Practice expense
- 12.34
- Malpractice
- 0.98
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.08 | × 1.000 | 12.0800 |
| Practice expense | 12.34 | × 0.915 | 11.2911 |
| Malpractice | 0.98 | × 0.397 | 0.3891 |
| Total RVUs | 23.7602 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$793.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.08 | 1 |
| Practice expense | 12.34 | 0.915 |
| Malpractice | 0.98 | 0.397 |
(12.08 × 1 + 12.34 × 0.915 + 0.98 × 0.397) × $33.4009 = $793.61
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.
66160 billing questions
How is 66160 distinguished from trabeculectomy codes?
Use 66160 when the surgeon performs iridencleisis, securing iris tissue in a scleral fistula. Trabeculectomy codes describe a different filtration technique.
Does the 90-day global period include postoperative visits?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral 66160 paid when modifier 50 is reported?
CMS pays a bilateral procedure reported with modifier 50 at 150%.
Can an assistant surgeon be paid for 66160?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What happens when 66160 is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and the other procedure or procedures are paid at 50% under the standard multiple procedure reduction.
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.
7,36266130,,Remove eye lesion,A,,7.63,12.90,,6.02,,0.62,21.15,14.27,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36366150,,Glaucoma surgery,A,,10.27,11.70,NA,11.70,,0.82,22.79,22.79,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36466155,,Glaucoma surgery,A,,10.26,11.70,NA,11.70,,0.82,22.78,22.78,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36566160,,Glaucoma surgery,A,,12.08,12.34,NA,12.34,,0.98,25.40,25.40,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36666170,,Glaucoma surgery,A,,13.59,13.41,NA,13.41,,1.09,28.09,28.09,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36766172,,Incision of eye,A,,14.47,15.18,NA,15.18,,1.16,30.81,30.81,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36866174,,Trluml dil aq o/f can w/o st,A,,7.43,8.17,NA,8.17,,0.58,16.18,16.18,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136