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CPT code 67101: Retinal repair, cryotherapy2026 Medicare rate & RVUs in Utah

Reports cryotherapy-based repair of an established retinal detachment, including drainage of subretinal fluid when performed.

CMS RVU26DEffective Oct 1, 2026One payment locality263 Medicare services in 2024

In Utah, Medicare pays $321.69 for 67101 in the office and $237.55 when it’s performed in a hospital or facility.

$321.69Office (non-facility)
$237.55Hospital or facility
−4.1%vs the national office rate ($335.35)

Check a contract rate as a % of Medicare · 67101 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 67101 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 67101 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 67101 covers

An ophthalmologist, often a retina specialist, applies transscleral cryotherapy to retinal breaks associated with an established detachment, creating an adhesion intended to seal the break. Drainage of subretinal fluid is included when performed. This approach differs from treating an isolated retinal tear before detachment and from repairs using a scleral buckle, vitrectomy, or injected gas. It may be performed in an office or surgical facility, depending on the case and setting.

Report 67101 when the documented repair uses cryotherapy. The operative note should establish the detachment, identify the treated break or breaks, and describe the cryotherapy and any fluid drainage. Related postoperative visits during the 10-day global period are included. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and the others at 50%; bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and 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 Utah compares for 67101

Across 109 of 109 payment localities, the office rate for 67101 runs from $301.13 in Arkansas to $437.89 in San Benito County, CA. Utah pays $321.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

67101 in Utah vs other payment areas
  1. Utah · this page$321.69
  2. Los Angeles, CA · California$376.03+$54.34
  3. Washington, DC area · District of Columbia$380.35+$58.66
  4. Miami, FL · Florida$357.35+$35.66
  5. Chicago, IL · Illinois$348.45+$26.76
  6. Manhattan, NY · New York$382.19+$60.50
  7. Alaska · Alaska$402.22+$80.53

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

Every other payment area

67101 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$304.98$226.66
ArkansasArkansas$301.13$224.24
ArizonaArizona$327.50$240.76
Bakersfield, CACalifornia$354.54$256.43
Chico, CACalifornia$353.68$255.57
El Centro, CACalifornia$353.72$255.61
Fresno, CACalifornia$353.68$255.57
Hanford, CACalifornia$353.68$255.57

67101 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$301.13

$402.22

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

View every state and territory as a table
67101 office rate range by state
State / territoryOffice rate rangeLocalities
AK$402.221
AL$304.981
AR$301.131
AZ$327.501
CA$353.68–$437.8929
CO$348.431
CT$355.831
DC$380.351
DE$332.481
FL$330.35–$357.353
GA$314.03–$340.842
GU$360.841
HI$360.841
IA$312.021
ID$313.751
IL$321.72–$348.594
IN$315.351
KS$310.611
KY$310.991
LA$310.51–$323.972
MA$346.68–$380.342
MD$338.33–$380.353
ME$315.04–$330.232
MI$317.95–$333.862
MN$335.401
MO$305.76–$325.153
MS$303.501
MT$335.331
NC$317.951
ND$330.191
NE$313.561
NH$342.981
NJ$360.32–$377.152
NM$319.431
NV$334.111
NY$322.13–$390.295
OH$316.901
OK$310.641
OR$331.91–$358.562
PA$317.42–$347.792
PR$337.561
RI$343.591
SC$317.871
SD$329.581
TN$311.961
TX$315.58–$346.928
UT$321.691
VA$329.17–$380.352
VI$337.561
VT$328.931
WA$346.03–$387.752
WI$320.401
WV$311.221
WY$333.091

See 67101 in every payment locality

How the 67101 rate is calculated

Each of 67101’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 · 67101

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.41

3.41 RVUs× 1.000 GPCI

Practice expense6.37

6.37 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

10.0400

Conversion factor

$33.4009

Medicare rate

$335.35

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,430

Code
67101
Physician work
3.41
Practice expense
6.37
Malpractice
0.26

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 67101 in Utah
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0003.4100
Practice expense6.37× 0.9405.9878
Malpractice0.26× 0.8980.2335
Total RVUs9.6313
Conversion factor× 33.4009

Office rate, Utah$321.69

Office: (3.41 × 1 + 6.37 × 0.94 + 0.26 × 0.898) × $33.4009 = $321.69

Facility: (3.41 × 1 + 3.69 × 0.94 + 0.26 × 0.898) × $33.4009 = $237.55

Open 67101 in the RVU calculator

Payment rules and modifiers for 67101

67101 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67101

Retinal repair, cryotherapy

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67101

Retinal repair, cryotherapy

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67101 without 50 · national office

$335.35

Retinal repair, cryotherapy

67101-50 · Bilateral: 150%

$503.03

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

Codes related to 67101

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 67101
CodeHow it relatesOffice range, Utah
Same family
67105Retinal detachment repair, photocoagulation methodSibling detachment-repair code using photocoagulation rather than cryotherapy.$286.97
Used instead
67107Retinal detachment repair, scleral buckle without vitrectomyUsed for detachment repair centered on scleral buckling.No office rate
67108Retinal detachment repair, vitrectomy-based repairUsed when detachment repair includes vitrectomy.No office rate
67110Retinal detachment repair, gas injection techniqueUsed for pneumatic retinopexy with gas injection.$856.88

How 67101 has changed in Utah

67101 · Office / nonfacility

$321.69

Effective 2026-10-01

The base rate is $14.15 higher than on 2025-10-01, moving from $307.54 to $321.69 (4.6%).

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

    $307.54changed to$321.69

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.50 changed to 3.41
    • Practice expense RVU 6.16 changed to 6.37
    • Malpractice RVU 0.28 changed to 0.26
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $318.35changed to$307.54

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.23 changed to 6.16
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $313.16changed to$318.35

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $318.88changed to$313.16

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.13 changed to 6.23
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $318.53changed to$318.88

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.99 changed to 6.13
    • Malpractice RVU 0.25 changed to 0.27
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $320.17changed to$318.53

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.95 changed to 5.99
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $323.09changed to$320.17

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.62 changed to 5.95
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $325.48changed to$323.09

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.64 changed to 5.62
    • Malpractice RVU 0.26 changed to 0.27
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $323.78changed to$325.48

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.60 changed to 5.64

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $319.66changed to$323.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.53 changed to 5.60
    • Malpractice RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $761.77changed to$319.66

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 8.80 changed to 3.50
    • Practice expense RVU 12.72 changed to 5.53
    • Malpractice RVU 0.64 changed to 0.25
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $763.86changed to$761.77

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.70 changed to 12.72

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $760.06changed to$763.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $793.24changed to$760.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.69 changed to 12.70
    • Malpractice RVU 1.48 changed to 0.64
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $790.09changed to$793.24

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.88 changed to 12.69
    • Malpractice RVU 1.55 changed to 1.48
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $790.09

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$321.69$237.55RVU26D
2026-07-01$321.69$237.55RVU26C
2026-04-01$321.69$237.55RVU26B
2026-01-01$321.69$237.55RVU26A
2025-10-01$307.54$262.87RVU25D
2025-07-01$307.54$262.87RVU25C
2025-04-01$307.54$262.87RVU25B
2025-01-01$307.54$262.87RVU25A
2024-10-01$318.35$270.83RVU24D
2024-07-01$318.35$270.83RVU24C
2024-04-01$318.35$270.83RVU24B
2024-03-09$318.35$270.83RVU24AR
2024-01-01$313.16$266.41RVU24A
2023-10-01$318.88$271.18RVU23D
2023-07-01$318.88$271.18RVU23C
2023-04-01$318.88$271.18RVU23B
2023-01-01$318.88$271.18RVU23A
2022-10-01$318.53$269.56RVU22D
2022-07-01$318.53$269.56RVU22C
2022-04-01$318.53$269.56RVU22B
2022-01-01$318.53$269.56RVU22A
2021-10-01$320.17$272.07RVU21D
2021-07-01$320.17$272.07RVU21C
2021-04-01$320.17$272.07RVU21B
2021-01-01$320.17$272.07RVU21A
2020-10-01$323.09$278.45RVU20D
2020-07-01$323.09$278.45RVU20C
2020-04-01$323.09$278.45RVU20B
2020-01-01$323.09$278.45RVU20A
2019-10-01$325.48$282.04RVU19D
2019-07-01$325.48$282.04RVU19C
2019-04-01$325.48$282.04RVU19B
2019-01-01$325.48$282.04RVU19A
2018-10-01$323.78$282.74RVU18D
2018-07-01$323.78$282.74RVU18C
2018-04-01$323.78$282.74RVU18B
2018-01-01$323.78$282.74RVU18AR1
2017-10-01$319.66$279.49RVU17D
2017-07-01$319.66$279.49RVU17C
2017-04-01$319.66$279.49RVU17B
2017-01-01$319.66$279.49RVU17A
2016-10-01$761.77$660.43RVU16D
2016-07-01$761.77$660.43RVU16C
2016-04-01$761.77$660.43RVU16B
2016-01-01$761.77$660.43RVU16A
2015-10-01$763.86$661.82RVU15D
2015-07-01$763.86$661.82RVU15C
2015-04-01$760.06$658.52RVU15B
2015-01-01$760.06$658.52RVU15A
2014-10-01$793.24$693.49RVU14D
2014-07-01$793.24$693.49RVU14C
2014-04-01$793.24$693.49RVU14B
2014-01-01$793.24$693.49RVU14A
2013-10-01$790.09$684.75RVU13D
2013-07-01$790.09$684.75RVU13C
2013-04-01$790.09$684.75RVU13B
2013-01-01$790.09$684.75RVU13AR

Price 67101 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

67101 billing questions

How does 67101 differ from 67105?

Both address an established retinal detachment, but 67101 uses cryotherapy and 67105 uses photocoagulation. The documentation should support the repair method performed.

Can subretinal fluid drainage be billed separately?

No. Drainage of subretinal fluid is included in 67101 when performed.

When is 67101 preferable to 67141?

67101 is for repair of an established retinal detachment. 67141 is used for prophylactic treatment of a retinal break when the goal is to prevent detachment.

How are bilateral services and multiple procedures handled?

Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Are postoperative visits included?

Related postoperative visits for 10 days are included in the minor-procedure global period.

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 67101PPRRVU2026_Oct_nonQPP.csv, line 7,430 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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