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

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 Vermont, Medicare pays $111.78 for 67028 in the office and $73.42 when it’s performed in a hospital or facility.

$111.78Office (non-facility)
$73.42Hospital or facility
−2.1%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 Vermont
  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 Vermont 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. Vermont pays $111.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

67028 in Vermont vs other payment areas
  1. Vermont · this page$111.78
  2. Los Angeles, CA · California$126.59+$14.81
  3. Washington, DC area · District of Columbia$128.53+$16.75
  4. Miami, FL · Florida$122.46+$10.68
  5. Chicago, IL · Illinois$119.64+$7.86
  6. Manhattan, NY · New York$129.71+$17.93
  7. Alaska · Alaska$140.11+$28.33

Other areas in Vermont 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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 67028 in Vermont
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0001.4000
Practice expense1.91× 0.9901.8909
Malpractice0.11× 0.5060.0557
Total RVUs3.3466
Conversion factor× 33.4009

Office rate, Vermont$111.78

Office: (1.4 × 1 + 1.91 × 0.99 + 0.11 × 0.506) × $33.4009 = $111.78

Facility: (1.4 × 1 + 0.75 × 0.99 + 0.11 × 0.506) × $33.4009 = $73.42

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 Vermont

67028 · Office / nonfacility

$111.78

Effective 2026-10-01

The base rate is $5.05 higher than on 2025-10-01, moving from $106.73 to $111.78 (4.7%).

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

    $106.73changed to$111.78

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $109.99changed to$106.73

    • 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

    $108.19changed to$109.99

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $111.64changed to$108.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.80 changed to 1.82
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $112.62changed to$111.64

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.75 changed to 1.80
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $113.55changed to$112.62

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $101.94changed to$113.55

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.31 changed to 1.75
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $103.27changed to$101.94

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.34 changed to 1.31
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $103.52changed to$103.27

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

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $102.77changed to$103.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.34 changed to 1.35
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $102.41changed to$102.77

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $102.54changed to$102.41

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

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $102.03changed to$102.54

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $104.08changed to$102.03

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.19 changed to 0.10
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$104.08

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$111.78$73.42RVU26D
2026-07-01$111.78$73.42RVU26C
2026-04-01$111.78$73.42RVU26B
2026-01-01$111.78$73.42RVU26A
2025-10-01$106.73$86.49RVU25D
2025-07-01$106.73$86.49RVU25C
2025-04-01$106.73$86.49RVU25B
2025-01-01$106.73$86.49RVU25A
2024-10-01$109.99$88.17RVU24D
2024-07-01$109.99$88.17RVU24C
2024-04-01$109.99$88.17RVU24B
2024-03-09$109.99$88.17RVU24AR
2024-01-01$108.19$86.73RVU24A
2023-10-01$111.64$89.34RVU23D
2023-07-01$111.64$89.34RVU23C
2023-04-01$111.64$89.34RVU23B
2023-01-01$111.64$89.34RVU23A
2022-10-01$112.62$90.10RVU22D
2022-07-01$112.62$90.10RVU22C
2022-04-01$112.62$90.10RVU22B
2022-01-01$112.62$90.10RVU22A
2021-10-01$113.55$91.20RVU21D
2021-07-01$113.55$91.20RVU21C
2021-04-01$113.55$91.20RVU21B
2021-01-01$113.55$91.20RVU21A
2020-10-01$101.94$99.39RVU20D
2020-07-01$101.94$99.39RVU20C
2020-04-01$101.94$99.39RVU20B
2020-01-01$101.94$99.39RVU20A
2019-10-01$103.27$101.08RVU19D
2019-07-01$103.27$101.08RVU19C
2019-04-01$103.27$101.08RVU19B
2019-01-01$103.27$101.08RVU19A
2018-10-01$103.52$102.06RVU18D
2018-07-01$103.52$102.06RVU18C
2018-04-01$103.52$102.06RVU18B
2018-01-01$103.52$102.06RVU18AR1
2017-10-01$102.77$101.32RVU17D
2017-07-01$102.77$101.32RVU17C
2017-04-01$102.77$101.32RVU17B
2017-01-01$102.77$101.32RVU17A
2016-10-01$102.41$100.62RVU16D
2016-07-01$102.41$100.62RVU16C
2016-04-01$102.41$100.62RVU16B
2016-01-01$102.41$100.62RVU16A
2015-10-01$102.54$100.73RVU15D
2015-07-01$102.54$100.73RVU15C
2015-04-01$102.03$100.23RVU15B
2015-01-01$102.03$100.23RVU15A
2014-10-01$104.08$102.64RVU14D
2014-07-01$104.08$102.64RVU14C
2014-04-01$104.08$102.64RVU14B
2014-01-01$104.08$102.64RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 67028 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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