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CMS RVU26D · Effective 2026-10-01

66170 Trabeculectomy Medicare reimbursement rates in Vermont

Reports an ab externo trabeculectomy to lower intraocular pressure by creating a guarded drainage pathway, without scarring from prior ocular surgery or trauma. Compare 66170 office and facility rates across CMS payment localities in Vermont.

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 66170 in Vermont?

Vermont 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

$915.77

1 of 1 localities have a supported rate.

Payment area: Vermont

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.

Find 66170 in your payment locality →

Glaucoma surgery

About 66170: Trabeculectomy without prior scarring

Reports an ab externo trabeculectomy to lower intraocular pressure by creating a guarded drainage pathway, without scarring from prior ocular surgery or trauma.

An ophthalmic surgeon performs this filtering operation to lower intraocular pressure, commonly for glaucoma that remains inadequately controlled with medication or laser treatment. The surgeon creates a guarded opening through the sclera so aqueous fluid can drain beneath the conjunctiva and form a filtering bleb. This code describes the procedure without scarring from previous ocular surgery or trauma; the presence of such scarring distinguishes the related 66172 service. The procedure is typically performed in an operating room, and the operative report should identify the eye, surgical approach, and relevant prior ocular history.

Report the service for the eye treated. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 66170

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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU13.59 · 48%
  • Practice expense (office) RVU13.41 · 48%
  • Malpractice RVU1.09 · 4%

7.2K

Medicare services in 2024 · #1642 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.

66170 compared with similar codes

Office rates for Vermont, from the same CMS release.

66172

Glaucoma surgery

Prior surgery or trauma scarring

No office rate

Choose 66170 for trabeculectomy without the specified prior-surgery or trauma scarring; 66172 is the corresponding service when that scarring is present.

66174

Canaloplasty

Without retained stent

No office rate

66174 describes transluminal dilation of the aqueous outflow canal without a retention device. It is a different approach from creating a trabeculectomy filtration pathway.

66180

Glaucoma shunt

With graft

No office rate

66180 involves aqueous shunt surgery with a graft. 66170 is a trabeculectomy rather than implantation of that shunt.

Compare 66170 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

Office and facility base rates · shared scale starting at $0

  • Vermont →

    Office / nonfacility

    Unavailable

    Facility

    $915.77

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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 66170 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

7,366

Code
66170
Physician work
13.59
Practice expense
13.41
Malpractice
1.09

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Facility calculation for 66170 in Vermont
ComponentRVULocality factorAdjusted
Physician work13.59× 1.00013.5900
Practice expense13.41× 0.99013.2759
Malpractice1.09× 0.5060.5515
Total RVUs27.4174
Conversion factor× 33.4009

Facility rate, Vermont$915.77

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work13.591
Practice expense13.410.99
Malpractice1.090.506

(13.59 × 1 + 13.41 × 0.99 + 1.09 × 0.506) × $33.4009 = $915.77

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.

66170 billing questions

When should 66172 be considered instead?

Use 66172 when scarring from previous ocular surgery or trauma is present. The operative documentation should support which condition applies.

How is bilateral trabeculectomy reported?

For bilateral surgery, report modifier 50; CMS pays this code at 150% under the stated bilateral rule.

Does the global period include postoperative visits?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How does the multiple-procedure reduction work?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What should the operative note establish?

Document the eye treated, the ab externo filtering procedure performed, and whether scarring from prior ocular surgery or trauma is present.

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.

RVUs for 66170PPRRVU2026_Oct_nonQPP.csv, line 7,366 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet