M a r c h 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 4 9
Transscleral cyclophotocoagu-
lation (Micropulse or G-Probe)
cPT code 66710
aSc Facility Fee…...............$796
hOPD Facility Fee........…$1,701
Case costs: Laser probes $210-
$500 per probe.
Iridex cyclo G6 Glaucoma
Laser system ~$25,000
Ex-PRESS shunt
cPT code 66183
aSc Facility Fee ….......... $1,744
hOPD Facility fee .......… $3,611
Shunt cost: $650-700 aSc,
$1,352 hospital
Total additional disposable
case costs reported at $496
Ab Interno Canaloplasty
cPT code 66174
aSc Facility Fee ….......... $1,744
hOPD Facility Fee ......… $3,611
Case costs: iTrack device: $795
aSc, $995 hospital
Volk reusable Gonioprism:
$674
healon/healon GV .85 ml: $40-
$50
MST Forcep handle: $450
(most facilities have the holder)
MST micro grasper tip: $450
27g Needle: $2
Visco 360: $1,600
Knives (sideport, primary) $30
Disposable gonioprism: $10-
$15 or reusable gonioprism
$600-$700
Viscoelastic: $40-$50
Trab 360: $1,600
Knives (sideport, primary) $30
Disposable gonioprism: $10-
$15 or reusable gonioprism
$600-$700
Viscoelastic: $40-$50
Ab-interno Goniotomy
cPT code 65820
aSc Facility Fee…$1,744
hOPD Facility Fee…$3,611
Case costs:Kahook blade: $425
Viscoelastic: $30
