$681.76–$727.46
66250 addresses revision or repair of an operative wound of the anterior segment, such as a leaking fistula. Use 66225 for repair of a scleral staphyloma with a graft.
On this page
CMS RVU26D · Effective 2026-10-01
66225 Scleral repair Medicare reimbursement rates in Missouri
Reports surgical repair of a scleral staphyloma using graft material to reinforce or reconstruct the weakened area of the eye wall. Compare 66225 office and facility rates across CMS payment localities in Missouri.
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 66225 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$744.28–$776.60
3 of 3 localities have a supported rate.
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 66225 pays more and less in Missouri
Ophthalmology surgery
About 66225: Scleral staphyloma repair with graft
Reports surgical repair of a scleral staphyloma using graft material to reinforce or reconstruct the weakened area of the eye wall.
An ophthalmic surgeon uses graft material to repair a scleral staphyloma, an abnormal outward bulging of weakened sclera. The graft reinforces or reconstructs the affected area; the specific material and technique depend on the operative findings. This is a major eye operation generally performed in a surgical setting, rather than a minor office repair.
Report this code when the operative documentation supports repair of a scleral staphyloma and use of a graft. The record should identify the affected eye, the staphyloma, the repair performed, and the graft used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery is not paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 66225
- 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 RVU12.31 · 52%
- Practice expense (office) RVU10.44 · 44%
- Malpractice RVU1.00 · 4%
49
Medicare services in 2024 · #5368 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.
66225 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
67255 describes scleral reinforcement with a graft for an indication other than repair of a scleral staphyloma. The diagnosis and operative purpose distinguish it from 66225.
Compare 66225 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$771.23
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$776.60
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$744.28
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66225 billing questions
When should 66225 be chosen instead of 66220?
Use 66225 when the scleral staphyloma repair includes a graft. The corresponding repair without a graft is reported with 66220.
What documentation supports reporting 66225?
Document the scleral staphyloma, the eye treated, the repair performed, and the graft used. The operative note should make clear that the graft was part of the staphyloma repair.
Does the 90-day global period include routine postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period.
How is bilateral repair reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The documentation should support repair of both eyes.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
7,37266183,,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
7,37866505,,Incision of iris,A,,4.11,7.01,NA,7.01,,0.34,11.46,11.46,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00