How much does Medicare pay for CPT 66174?

Medicare allowed an average of $1015.39 per service and paid $807.60 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4651.63, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 66174?

Dilation of fluid outflow drainage within eye. It was billed 26,731 times to 17,785 Medicare beneficiaries by 650 providers in 2024.

Does 66174 pay differently in an office than a hospital?

Yes. The allowed amount averaged $446.39 in an office setting and $1019.49 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 66174 most?

Ambulatory Surgical Center, with 14,229 services from 315 clinicians. Next are Ophthalmology.

CPT 66174

Dilation of fluid outflow drainage within eye

$1015.39Medicare-allowed amount per service, averaged across 26,731 services

Providers submitted

$4651.63

Asking price, not received

Medicare allowed

$1015.39

The fee schedule figure

Medicare paid

$807.60

Balance is patient coinsurance

Providers submitted an average of $4651.63 for this code and Medicare allowed $1015.39 — 4.6× 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 $807.60 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $446.39
Hospital / facility: $1019.49

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 191 services were billed in an office setting and 26,540 in a facility.

Services: 26,731
Beneficiaries: 17,785
Providers billing it: 650
Total allowed: $27,142,390

What Medicare pays for CPT 66174

Across 26,731 services billed by 650 providers to 17,785 beneficiaries, Medicare allowed an average of $1015.39 per service. That is 1.5 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 66174

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	14,229	9,553	$1524.03	315
Ophthalmology	12,502	8,232	$436.49	335

66174 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	5,618	$1080.68	$731.57	121
Florida	3,057	$983.55	$824.95	69
Texas	1,646	$940.54	$785.04	46
Pennsylvania	1,348	$829.33	$681.36	27
Arizona	1,286	$1081.79	$866.22	19
Maryland	1,258	$1055.18	$841.50	25
New Jersey	1,206	$1092.52	$809.36	29
Alabama	713	$739.47	$696.58	10
Virginia	705	$1284.11	$1054.19	17
Illinois	614	$1192.38	$947.71	19
Ohio	594	$1022.80	$872.24	20
Tennessee	577	$997.97	$875.48	12
Oklahoma	494	$1114.64	$947.74	11
Missouri	472	$831.49	$696.97	13
Louisiana	438	$713.24	$497.96	8
Utah	402	$816.70	$688.55	12
Colorado	394	$1004.73	$796.40	11
Michigan	386	$979.12	$847.20	13
New York	360	$1458.29	$1062.27	12
Mississippi	359	$865.59	$800.41	7
Kentucky	344	$890.38	$766.63	12
Massachusetts	330	$993.31	$765.98	10
Indiana	317	$978.31	$805.01	9
Nevada	314	$1045.66	$837.08	9
Hawaii	302	$1323.45	$943.30	6
Kansas	287	$1141.09	$981.72	7
North Carolina	261	$663.68	$562.89	7
Arkansas	259	$1244.78	$1126.49	8
Georgia	251	$1394.27	$1156.27	9
Wisconsin	240	$918.22	$760.30	6
Idaho	225	$864.67	$740.87	7
Washington	187	$1158.10	$896.65	8
South Dakota	181	$987.36	$858.09	6
South Carolina	173	$1346.87	$1152.42	7
Iowa	163	$1008.84	$879.16	6
New Hampshire	145	$958.53	$766.83	5
Delaware	141	$690.82	$531.52	2
Montana	135	$921.63	$759.60	4
Minnesota	105	$723.78	$562.35	5
West Virginia	101	$900.96	$805.76	3
Rhode Island	91	$455.07	$350.48	2
Nebraska	47	$1057.32	$864.18	2
Connecticut	46	$382.79	$288.67	2
New Mexico	42	$1135.79	$951.20	2
Maine	33	$662.01	$546.34	2
Guam	29	$1326.79	$1071.49	1
North Dakota	28	$458.90	$369.94	1
Oregon	27	$388.74	$289.00	1

Related codes

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
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.