CPT code 67028: Intravitreal injection, medication delivered into vitreous cavity2026 Medicare rate & RVUs in Puerto Rico

Intravitreal medication injection through the pars plana is reported for a treated eye, commonly for neovascular macular degeneration, diabetic macular edema, or retinal vein occlusion.

CMS RVU26DEffective Oct 1, 2026One payment locality3.6M Medicare services in 2024

In Puerto Rico, Medicare pays $114.88 for 67028 in the office and $75.71 when it’s performed in a hospital or facility.

$114.88Office (non-facility)
$75.71Hospital or facility
+0.6%vs the national office rate ($114.23)

Check a contract rate as a % of Medicare · 67028 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 67028 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 67028 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 67028 covers

A retina specialist or ophthalmologist injects medication through the pars plana into the vitreous cavity after ocular anesthesia and antiseptic preparation, often using a lid speculum. Intravitreal anti-VEGF treatment is common for neovascular age-related macular degeneration, diabetic macular edema, and macular edema from retinal vein occlusion; steroids and antibiotics are other possible agents. Injections occur primarily in the office but may also take place in an outpatient facility. The procedure code captures the injection; the medication supplied is reported separately under its applicable HCPCS drug code.

Document laterality, medication and dose, indication, and injection technique. For one treated eye, report one unit with RT or LT; for both eyes in the same session, report one unit with modifier 50, paid at 150% of the unilateral amount. CMS assigns a 0-day global period, including same-day preoperative and postoperative care; a separately identifiable E/M requires modifier 25. When multiple procedures are performed in the same session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 67028

Across 109 of 109 payment localities, the office rate for 67028 runs from $103.45 in Arkansas to $145.87 in San Benito County, CA. Puerto Rico pays $114.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

67028 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$114.88
  2. Los Angeles, CA · California$126.59+$11.71
  3. Washington, DC area · District of Columbia$128.53+$13.65
  4. Miami, FL · Florida$122.46+$7.58
  5. Chicago, IL · Illinois$119.64+$4.76
  6. Manhattan, NY · New York$129.71+$14.83
  7. Alaska · Alaska$140.11+$25.23

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

67028 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$104.66$70.76
ArkansasArkansas$103.45$70.17
ArizonaArizona$111.72$74.18
Bakersfield, CACalifornia$119.81$77.34
Chico, CACalifornia$119.45$76.98
El Centro, CACalifornia$119.46$77.00
Fresno, CACalifornia$119.45$76.98
Hanford, CACalifornia$119.45$76.98

67028 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$103.45

$140.11

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
67028 office rate range by state
State / territoryOffice rate rangeLocalities
AK$140.111
AL$104.661
AR$103.451
AZ$111.721
CA$119.45–$145.8729
CO$118.071
CT$120.851
DC$128.531
DE$113.331
FL$113.27–$122.463
GA$108.05–$116.132
GU$121.421
HI$121.421
IA$106.591
ID$107.191
IL$110.75–$119.644
IN$107.691
KS$106.281
KY$106.841
LA$106.74–$110.972
MA$117.61–$128.122
MD$115.16–$128.533
ME$107.74–$112.302
MI$109.15–$114.522
MN$113.491
MO$105.33–$111.183
MS$104.401
MT$114.221
NC$108.631
ND$112.051
NE$107.031
NH$116.391
NJ$122.33–$127.632
NM$109.671
NV$113.681
NY$109.95–$132.435
OH$108.711
OK$106.591
OR$112.88–$121.122
PA$108.80–$118.402
PR$114.881
RI$116.831
SC$108.831
SD$111.791
TN$106.721
TX$108.23–$117.618
UT$110.031
VA$112.07–$128.532
VI$114.881
VT$111.781
WA$117.34–$130.382
WI$109.011
WV$107.461
WY$113.281

See 67028 in every payment locality

How the 67028 rate is calculated

Each of 67028’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 67028

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.40

1.40 RVUs× 1.000 GPCI

Practice expense1.91

1.91 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

3.4200

Conversion factor

$33.4009

Medicare rate

$114.23

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,421

Code
67028
Physician work
1.40
Practice expense
1.91
Malpractice
0.11

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 67028 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0001.4000
Practice expense1.91× 1.0111.9310
Malpractice0.11× 0.9850.1084
Total RVUs3.4394
Conversion factor× 33.4009

Office rate, Puerto Rico$114.88

Office: (1.4 × 1 + 1.91 × 1.011 + 0.11 × 0.985) × $33.4009 = $114.88

Facility: (1.4 × 1 + 0.75 × 1.011 + 0.11 × 0.985) × $33.4009 = $75.71

Open 67028 in the RVU calculator

Payment rules and modifiers for 67028

The CMS indicators that decide how 67028 is paid alongside other services.

CMS payment indicators · 67028

Intravitreal injection, medication delivered into vitreous cavity

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67028 without 50 · national office

$114.23

Intravitreal injection, medication delivered into vitreous cavity

67028-50 · Bilateral: 150%

$171.35

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 67028 has changed in Puerto Rico

67028 · Office / nonfacility

$114.88

Effective 2026-10-01

The base rate is $5.53 higher than on 2025-10-01, moving from $109.35 to $114.88 (5.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $109.35changed to$114.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.44 changed to 1.40
    • Practice expense RVU 1.81 changed to 1.91
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $112.54changed to$109.35

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.82 changed to 1.81
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $110.70changed to$112.54

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.95changed to$110.70

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.80 changed to 1.82
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $113.52changed to$113.95

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $114.63changed to$113.52

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.75 changed to 1.80
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $115.58changed to$114.63

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $103.55changed to$115.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.31 changed to 1.75
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $104.45changed to$103.55

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.34 changed to 1.31
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $104.70changed to$104.45

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.35 changed to 1.34

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $95.38changed to$104.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.34 changed to 1.35
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $86.54changed to$95.38

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $86.74changed to$86.54

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.10 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $86.31changed to$86.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $86.65changed to$86.31

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.19 changed to 0.10
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $84.14changed to$86.65

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.45 changed to 1.34
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $84.14

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$114.88$75.71RVU26D
2026-07-01$114.88$75.71RVU26C
2026-04-01$114.88$75.71RVU26B
2026-01-01$114.88$75.71RVU26A
2025-10-01$109.35$88.83RVU25D
2025-07-01$109.35$88.83RVU25C
2025-04-01$109.35$88.83RVU25B
2025-01-01$109.35$88.83RVU25A
2024-10-01$112.54$90.41RVU24D
2024-07-01$112.54$90.41RVU24C
2024-04-01$112.54$90.41RVU24B
2024-03-09$112.54$90.41RVU24AR
2024-01-01$110.70$88.94RVU24A
2023-10-01$113.95$91.41RVU23D
2023-07-01$113.52$91.16RVU23C
2023-04-01$113.52$91.16RVU23B
2023-01-01$113.52$91.16RVU23A
2022-10-01$114.63$91.96RVU22D
2022-07-01$114.63$91.96RVU22C
2022-04-01$114.63$91.96RVU22B
2022-01-01$114.63$91.96RVU22A
2021-10-01$115.58$93.07RVU21D
2021-07-01$115.58$93.07RVU21C
2021-04-01$115.58$93.07RVU21B
2021-01-01$115.58$93.07RVU21A
2020-10-01$103.55$101.00RVU20D
2020-07-01$103.55$101.00RVU20C
2020-04-01$103.55$101.00RVU20B
2020-01-01$103.55$101.00RVU20A
2019-10-01$104.45$102.27RVU19D
2019-07-01$104.45$102.27RVU19C
2019-04-01$104.45$102.27RVU19B
2019-01-01$104.45$102.27RVU19A
2018-10-01$104.70$103.25RVU18D
2018-07-01$104.70$103.25RVU18C
2018-04-01$104.70$103.25RVU18B
2018-01-01$104.70$103.25RVU18AR1
2017-10-01$95.38$94.15RVU17D
2017-07-01$95.38$94.15RVU17C
2017-04-01$95.38$94.15RVU17B
2017-01-01$95.38$94.15RVU17A
2016-10-01$86.54$85.27RVU16D
2016-07-01$86.54$85.27RVU16C
2016-04-01$86.54$85.27RVU16B
2016-01-01$86.54$85.27RVU16A
2015-10-01$86.74$85.48RVU15D
2015-07-01$86.74$85.48RVU15C
2015-04-01$86.31$85.05RVU15B
2015-01-01$86.31$85.05RVU15A
2014-10-01$86.65$85.66RVU14D
2014-07-01$86.65$85.66RVU14C
2014-04-01$86.65$85.66RVU14B
2014-01-01$86.65$85.66RVU14A
2013-10-01$84.14$82.98RVU13D
2013-07-01$84.14$82.98RVU13C
2013-04-01$84.14$82.98RVU13B
2013-01-01$84.14$82.98RVU13AR

Price 67028 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

67028 billing questions

Is the drug included in this code?

No. The code covers the injection procedure. Bill the medication separately using its applicable HCPCS code, such as J0178 for aflibercept or J2778 for ranibizumab, with units based on the dose supplied.

How are injections in both eyes in the same session billed to Medicare?

Report one procedure unit with modifier 50, which CMS pays at 150% of the unilateral amount. Report drug units based on the dose supplied for both eyes.

Can an office visit be billed on the injection day?

Yes, if the documentation supports a significant, separately identifiable E/M service beyond routine injection-related assessment and care; append modifier 25 to the E/M code. A planned injection visit with only brief pre-injection assessment is included in the 0-day global period.

Can retinal OCT be billed on an injection day?

Retinal OCT (92134) may be reported on the same date when it is medically necessary to assess the retina and its interpretation is documented.

Should this code be reported for a drug injected during vitrectomy?

An injection integral to a vitrectomy in the same eye is not reported separately as 67028. Use 67028 for a distinct intravitreal injection service.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 67028PPRRVU2026_Oct_nonQPP.csv, line 7,421 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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