How much does Medicare pay for CPT 66030?

Medicare allowed an average of $417.09 per service and paid $327.82 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $997.93, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 66030?

Injection of medication into eye. It was billed 7,700 times to 4,658 Medicare beneficiaries by 176 providers in 2024.

Does 66030 pay differently in an office than a hospital?

Yes. The allowed amount averaged $181.47 in an office setting and $637.78 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 66030 most?

Ophthalmology, with 5,728 services from 145 clinicians. Next are Ambulatory Surgical Center.

CPT 66030

Injection of medication into eye

$417.09Medicare-allowed amount per service, averaged across 7,700 services

Providers submitted

$997.93

Asking price, not received

Medicare allowed

$417.09

The fee schedule figure

Medicare paid

$327.82

Balance is patient coinsurance

Providers submitted an average of $997.93 for this code and Medicare allowed $417.09 — 2.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $327.82 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $181.47
Hospital / facility: $637.78

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 3,724 services were billed in an office setting and 3,976 in a facility.

Services: 7,700
Beneficiaries: 4,658
Providers billing it: 176
Total allowed: $3,211,593

What Medicare pays for CPT 66030

Across 7,700 services billed by 176 providers to 4,658 beneficiaries, Medicare allowed an average of $417.09 per service. That is 1.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 66030

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	5,728	3,532	$155.58	145
Ambulatory Surgical Center	1,972	1,126	$1176.70	31

66030 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	2,754	$607.19	$427.18	31
Florida	1,005	$396.28	$337.29	26
Texas	468	$325.59	$270.91	13
Massachusetts	387	$289.44	$205.88	11
Alabama	347	$470.63	$446.85	6
Pennsylvania	252	$170.53	$133.64	6
Virginia	236	$172.13	$133.24	7
New York	201	$206.88	$136.61	6
Georgia	180	$417.05	$348.73	4
Missouri	175	$518.11	$429.99	4
Maryland	148	$253.00	$181.89	5
Illinois	138	$321.13	$244.54	6
Tennessee	126	$310.79	$277.65	5
South Carolina	126	$153.28	$118.44	4
Arizona	125	$183.88	$144.25	5
Mississippi	123	$522.33	$480.92	3
New Jersey	113	$186.96	$113.32	4
Michigan	91	$139.62	$110.88	4
Oregon	70	$202.34	$132.85	1
Utah	70	$159.67	$139.30	1
Connecticut	60	$274.23	$183.73	2
North Carolina	57	$113.03	$94.31	2
Arkansas	54	$554.12	$506.60	2
Ohio	49	$161.13	$139.46	2
Louisiana	48	$579.31	$502.31	2
District of Columbia	36	$180.85	$130.80	1
Colorado	36	$183.71	$145.66	2
Nebraska	30	$91.32	$79.76	1
Minnesota	28	$158.95	$120.85	2
Kansas	24	$90.78	$77.61	1
Wisconsin	24	$166.64	$138.58	1
New Mexico	23	$173.49	$138.64	1
South Dakota	22	$162.58	$126.26	1
Rhode Island	21	$180.61	$138.84	1
Montana	21	$186.00	$147.22	1
Maine	17	$170.29	$138.18	1
Wyoming	15	$179.18	$143.47	1

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.