How much does Medicare pay for CPT 66170?

Medicare allowed an average of $1014.77 per service and paid $804.17 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3838.65, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 66170?

Creation of eye fluid drainage tract for treatment of glaucoma. It was billed 3,369 times to 2,983 Medicare beneficiaries by 145 providers in 2024.

Does 66170 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1005.84 in an office setting and $1014.81 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 66170 most?

Ophthalmology, with 1,715 services from 76 clinicians. Next are Ambulatory Surgical Center.

CPT 66170

Creation of eye fluid drainage tract for treatment of glaucoma

$1014.77Medicare-allowed amount per service, averaged across 3,369 services

Providers submitted

$3838.65

Asking price, not received

Medicare allowed

$1014.77

The fee schedule figure

Medicare paid

$804.17

Balance is patient coinsurance

Providers submitted an average of $3838.65 for this code and Medicare allowed $1014.77 — 3.8× 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 $804.17 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1005.84
Hospital / facility: $1014.81

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 16 services were billed in an office setting and 3,353 in a facility.

Services: 3,369
Beneficiaries: 2,983
Providers billing it: 145
Total allowed: $3,418,760

What Medicare pays for CPT 66170

Across 3,369 services billed by 145 providers to 2,983 beneficiaries, Medicare allowed an average of $1014.77 per service. 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 66170

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	1,715	1,509	$1057.93	76
Ambulatory Surgical Center	1,654	1,474	$970.01	69

66170 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
Florida	411	$1015.77	$820.77	18
California	385	$1190.66	$798.36	19
Pennsylvania	342	$1042.85	$789.91	11
Arkansas	292	$812.88	$711.75	4
Indiana	245	$983.62	$796.23	5
Maryland	241	$1004.31	$753.35	8
Texas	206	$957.73	$790.45	12
Ohio	169	$969.26	$803.58	9
Delaware	138	$1015.84	$799.85	5
New Jersey	108	$836.82	$626.25	4
Washington	96	$1118.41	$819.32	5
New York	89	$1201.54	$845.87	4
North Carolina	83	$976.47	$812.88	5
Virginia	75	$1036.78	$873.24	4
Massachusetts	68	$1077.75	$805.55	5
New Hampshire	61	$1096.14	$869.62	4
Oregon	54	$1135.14	$873.76	3
Alabama	43	$959.18	$852.82	3
Mississippi	42	$963.94	$873.70	2
South Carolina	37	$905.12	$733.99	3
Nevada	36	$987.12	$731.26	2
Iowa	30	$969.32	$849.55	2
Georgia	28	$1116.39	$880.92	2
Louisiana	26	$1022.20	$887.50	2
Illinois	21	$886.64	$773.27	1
Utah	17	$1027.83	$821.90	1
Minnesota	14	$1102.76	$839.69	1
Wisconsin	12	$866.64	$695.95	1

Related codes

66174Dilation of fluid outflow drainage within eye$1015.39
66180Creation of shunt to improve eye fluid flow$1714.60
66183Insertion of eye fluid drainage device$1844.09
66172Creation of eye fluid drainage tract for treatment of glaucoma$1111.47

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.