CPT code 67218: Retinal treatment, radiation method2026 Medicare rate & RVUs in Michigan
Reports radiation-based treatment of a localized retinal lesion, such as a tumor, when the ophthalmic surgeon treats the lesion with radiation rather than laser or cryotherapy.
CMS doesn’t publish an office rate for 67218 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 67218 covers
This service treats a localized retinal lesion with radiation, commonly through plaque brachytherapy for an intraocular tumor. An ophthalmic surgeon performs the procedure in an operating-room setting, positioning the radiation source to deliver treatment to the targeted area. The exact approach depends on the lesion and treatment plan; this code distinguishes radiation treatment from retinal lesion treatment by photocoagulation or cryotherapy.
Report the code when the treated target is in the retina and radiation is the treatment method. The operative record should identify the lesion and its location, the radiation approach, and the treatment performed. The code covers one or more treatment sessions. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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.
Where 67218 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $1,175.83 |
| Rest of Michigan | Unavailable | $1,123.60 |
How the 67218 rate is calculated
Each of 67218’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 · 67218
RVUs × geographic indexes × conversion factor
Work19.85
19.85 RVUs× 1.000 GPCI
Practice expense13.15
13.15 RVUs× 1.000 GPCI
Malpractice1.58
1.58 RVUs× 1.000 GPCI
Adjusted RVUs
34.5800
Conversion factor
$33.4009
Medicare rate
$1,155.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67218
67218 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67218
Retinal treatment, radiation method
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67218
Retinal treatment, radiation method
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67218 without 50 · national facility
$1,155.00
Retinal treatment, radiation method
67218-50 · Bilateral: 150%
$1,732.50
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).
67218 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67208Retinal treatmentCryotherapy
- Select 67208 for retinal lesion destruction using cryotherapy or diathermy. Select 67218 when radiation is the treatment method.
- 67210Retinal laserLocalized lesion photocoagulation
- Select 67210 for retinal lesion treatment by photocoagulation. Radiation-based retinal treatment is reported with 67218.
- 67220Choroidal lesion treatmentLaser photocoagulation
- 67220 concerns a localized lesion of the choroid. Use 67218 for a retinal target treated with radiation.
67218 billing questions
How does this differ from 67208 or 67210?
Use 67218 when radiation is used to treat the retinal lesion. Codes 67208 and 67210 distinguish treatment using cryotherapy or diathermy and photocoagulation, respectively.
Does the code include multiple treatment sessions?
Yes. The code covers one or more sessions for the retinal lesion; do not report another unit solely because treatment involves more than one session.
What documentation supports reporting 67218?
Document the retinal lesion and its location, the radiation method, and the treatment performed. The record should support that radiation, rather than laser or cryotherapy, was used.
Can modifier 50 be used for bilateral treatment?
CMS identifies this as a bilateral procedure. When reported bilaterally with modifier 50, it is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid for this procedure?
CMS restricts assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
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
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