No office rate
66625 describes a peripheral iridectomy for glaucoma. Use 66635 when the operative plan removes the iris throughout its extent.
On this page
CMS RVU26D · Effective 2026-10-01
66635 Iris removal Medicare reimbursement rates in Pennsylvania
Report total iridectomy when an ophthalmic surgeon removes the iris throughout its extent rather than excising only a peripheral or sector portion. Compare 66635 office and facility rates across CMS payment localities in Pennsylvania.
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 66635 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$470.63–$508.15
2 of 2 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.
Ophthalmic surgery
About 66635: Total iris excision
Report total iridectomy when an ophthalmic surgeon removes the iris throughout its extent rather than excising only a peripheral or sector portion.
This operation removes the iris throughout its extent through a corneal or corneoscleral surgical approach. An ophthalmic surgeon performs it in an operating room, typically in a hospital or ambulatory surgery center, when the clinical plan calls for complete iris excision rather than removal of only a localized portion. The operative report should identify the indication and document that the excision was total; a peripheral or sector iridectomy is a different extent of surgery.
Choose this code based on the extent and purpose of the iris procedure, not simply because iris tissue was removed. Document the operative approach and the tissue removed so the record supports complete excision rather than a glaucoma-related peripheral iridectomy, sector iridectomy, or lesion-focused procedure. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 66635
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.19 · 49%
- Practice expense (office) RVU6.93 · 47%
- Malpractice RVU0.57 · 4%
22
Medicare services in 2024 · #5880 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.
66635 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
66630 is for sector excision, limited to part of the iris; 66635 represents complete excision.
No office rate
66600 is the lesion-focused iris excision code. Choose 66635 when the documented procedure is total iris removal rather than excision centered on a lesion.
No office rate
66680 describes iris or ciliary body repair. It is used when the tissue is repaired, not when the iris is completely excised.
Compare 66635 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$508.15
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$470.63
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66635 billing questions
How does this differ from a sector iridectomy?
This code is for removal throughout the iris. A sector iridectomy removes only a portion and is reported with 66630.
When is 66625 more appropriate?
Use 66625 for a peripheral iridectomy performed for glaucoma. This code describes complete iris excision.
Does the 90-day global period include postoperative care?
Yes. Related postoperative care for 90 days and the day-before preoperative visit are included in the global period.
How is bilateral surgery reported?
Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.
What documentation supports choosing this code?
The operative report should establish the indication and that the surgeon removed the iris throughout its extent, rather than performing a partial or lesion-focused excision.
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.
7,38066605,,Removal of iris,A,,13.86,12.77,NA,12.77,,1.11,27.74,27.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,38166625,,Removal of iris,A,,5.17,5.52,NA,5.52,,0.41,11.10,11.10,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,38266630,,Removal of iris,A,,7.10,6.90,NA,6.90,,0.56,14.56,14.56,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,38366635,,Removal of iris,A,,7.19,6.93,NA,6.93,,0.57,14.69,14.69,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,38466680,,Repair iris & ciliary body,A,,7.77,6.81,NA,6.81,,0.61,15.19,15.19,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,38566682,,Repair iris & ciliary body,A,,8.52,7.77,NA,7.77,,0.67,16.96,16.96,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,38666683,,Implantation iris prosthesis,A,,10.40,8.56,NA,8.56,,0.83,19.79,19.79,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00