How much does Medicare pay for CPT 66172?

Medicare allowed an average of $1111.47 per service and paid $881.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4140.16, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 66172?

Creation of eye fluid drainage tract for treatment of glaucoma with previous scarring. It was billed 1,079 times to 1,012 Medicare beneficiaries by 52 providers in 2024.

Which specialty bills 66172 most?

Ophthalmology, with 595 services from 29 clinicians. Next are Ambulatory Surgical Center.

CPT 66172

Creation of eye fluid drainage tract for treatment of glaucoma with previous scarring

$1111.47Medicare-allowed amount per service, averaged across 1,079 services

Providers submitted

$4140.16

Asking price, not received

Medicare allowed

$1111.47

The fee schedule figure

Medicare paid

$881.81

Balance is patient coinsurance

Providers submitted an average of $4140.16 for this code and Medicare allowed $1111.47 — 3.7× 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 $881.81 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,079
Beneficiaries: 1,012
Providers billing it: 52
Total allowed: $1,199,276

What Medicare pays for CPT 66172

Across 1,079 services billed by 52 providers to 1,012 beneficiaries, Medicare allowed an average of $1111.47 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 66172

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	595	560	$1123.97	29
Ambulatory Surgical Center	484	452	$1096.12	23

66172 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
New York	237	$1013.83	$686.08	8
New Jersey	113	$1211.88	$887.11	3
California	97	$1259.23	$877.05	5
Arkansas	83	$869.57	$800.87	2
Ohio	64	$1106.61	$921.66	4
Pennsylvania	57	$1194.01	$898.01	3
Texas	54	$1100.20	$919.93	3
Nebraska	53	$1097.16	$897.67	2
Michigan	51	$1108.92	$904.00	2
Illinois	47	$1159.16	$916.56	4
Florida	40	$1154.20	$913.44	3
Oregon	32	$1211.49	$916.67	2
Arizona	31	$1160.50	$923.85	2
Kansas	30	$1075.58	$898.46	2
Maryland	24	$1025.35	$805.09	2
Nevada	16	$1194.57	$909.10	1
Indiana	14	$1140.35	$927.91	1
Georgia	13	$1168.38	$927.94	1
Alaska	12	$1473.53	$924.98	1
Connecticut	11	$1320.70	$926.13	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
66170Creation of eye fluid drainage tract for treatment of glaucoma$1014.77

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.