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CPT code 67225: Photodynamic therapy, second eye, same session2026 Medicare rate & RVUs in Delaware

Reports photodynamic treatment of the fellow eye during the same session as primary-eye therapy for a choroidal lesion, billed as an add-on.

CMS RVU26DEffective Oct 1, 2026One payment locality56 Medicare services in 2024

In Delaware, Medicare pays $28.85 for 67225 in the office and $21.92 when it’s performed in a hospital or facility.

$28.85Office (non-facility)
$21.92Hospital or facility
−0.7%vs the national office rate ($29.06)

Check a contract rate as a % of Medicare · 67225 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 67225 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 67225 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 67225 covers

This add-on represents photodynamic therapy to the second eye during the same session as treatment of the first eye. An ophthalmologist, often a retina specialist, uses an intravenous photosensitizing drug followed by laser activation to treat a targeted choroidal lesion, such as choroidal neovascularization. Treatment may occur in an ophthalmology office or an outpatient facility, depending on the practice and setting.

Report this code only with the primary photodynamic therapy procedure when both eyes are treated in the same session. Documentation should identify both treated eyes, the choroidal condition, and the treatment performed in each eye. CMS classifies the code as an add-on: it is billed only with a primary procedure, and payment is included within that procedure's global period. It does not represent a separate session for later treatment of the other eye.

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 Delaware compares for 67225

Across 109 of 109 payment localities, the office rate for 67225 runs from $26.67 in Arkansas to $36.94 in Alaska. Delaware pays $28.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

67225 in Delaware vs other payment areas
  1. Delaware · this page$28.85
  2. Los Angeles, CA · California$31.50+$2.65
  3. Washington, DC area · District of Columbia$32.24+$3.39
  4. Miami, FL · Florida$31.61+$2.76
  5. Chicago, IL · Illinois$30.96+$2.11
  6. Manhattan, NY · New York$32.83+$3.98
  7. Alaska · Alaska$36.94+$8.09

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

Every other payment area

67225 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$26.93$20.80
ArkansasArkansas$26.67$20.64
ArizonaArizona$28.48$21.69
Bakersfield, CACalifornia$30.01$22.33
Chico, CACalifornia$29.89$22.20
El Centro, CACalifornia$29.89$22.21
Fresno, CACalifornia$29.89$22.20
Hanford, CACalifornia$29.89$22.20

67225 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.

$26.67

$36.94

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

View every state and territory as a table
67225 office rate range by state
State / territoryOffice rate rangeLocalities
AK$36.941
AL$26.931
AR$26.671
AZ$28.481
CA$29.89–$35.5929
CO$29.741
CT$30.601
DC$32.241
DE$28.851
FL$29.19–$31.613
GA$27.98–$29.572
GU$30.191
HI$30.191
IA$27.201
ID$27.371
IL$28.74–$30.964
IN$27.471
KS$27.211
KY$27.571
LA$27.58–$28.512
MA$29.69–$31.942
MD$29.25–$32.243
ME$27.57–$28.452
MI$28.16–$29.542
MN$28.481
MO$27.32–$28.473
MS$26.991
MT$29.061
NC$27.751
ND$28.271
NE$27.281
NH$29.401
NJ$30.94–$32.092
NM$28.301
NV$28.851
NY$28.04–$33.525
OH$27.991
OK$27.441
OR$28.61–$30.332
PA$27.97–$30.102
PR$29.171
RI$29.611
SC$27.921
SD$28.171
TN$27.321
TX$27.85–$29.658
UT$28.181
VA$28.46–$32.242
VI$29.171
VT$28.281
WA$29.59–$32.392
WI$27.621
WV$28.021
WY$28.711

See 67225 in every payment locality

How the 67225 rate is calculated

Each of 67225’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 · 67225

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.46

0.46 RVUs× 1.000 GPCI

Practice expense0.37

0.37 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

0.8700

Conversion factor

$33.4009

Medicare rate

$29.06

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,446

Code
67225
Physician work
0.46
Practice expense
0.37
Malpractice
0.04

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 67225 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.46× 1.0050.4623
Practice expense0.37× 0.9880.3656
Malpractice0.04× 0.8990.0360
Total RVUs0.8638
Conversion factor× 33.4009

Office rate, Delaware$28.85

Office: (0.46 × 1.005 + 0.37 × 0.988 + 0.04 × 0.899) × $33.4009 = $28.85

Facility: (0.46 × 1.005 + 0.16 × 0.988 + 0.04 × 0.899) × $33.4009 = $21.92

Open 67225 in the RVU calculator

Payment rules and modifiers for 67225

The CMS indicators that decide how 67225 is paid alongside other services.

CMS payment indicators · 67225

Photodynamic therapy, second eye, same session

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

Codes related to 67225

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

Codes related to 67225
CodeHow it relatesOffice range, Delaware
Add-on codes
67221Photodynamic therapy, choroidal lesionPrimary photodynamic therapy procedure to report with this same-session second-eye add-on.$281.97
Used instead
67220Choroidal lesion treatment, laser photocoagulationChoroidal lesion treatment by photocoagulation rather than photodynamic therapy.$527.78
67210Retinal laser, localized lesion photocoagulationPhotocoagulation for a localized retinal lesion, rather than photodynamic treatment of a choroidal lesion.$513.24

How 67225 has changed in Delaware

67225 · Office / nonfacility

$28.85

Effective 2026-10-01

The base rate is $0.73 higher than on 2025-10-01, moving from $28.12 to $28.85 (2.6%).

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

    $28.12changed to$28.85

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.47 changed to 0.46
    • Practice expense RVU 0.36 changed to 0.37
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $28.61changed to$28.12

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.35 changed to 0.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $28.14changed to$28.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $29.25changed to$28.14

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $29.65changed to$29.25

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.34 changed to 0.35
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $29.90changed to$29.65

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $31.07changed to$29.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.33 changed to 0.34
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $30.75changed to$31.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.34 changed to 0.33
    • Malpractice RVU 0.03 changed to 0.05
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $31.09changed to$30.75

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.35 changed to 0.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $30.73changed to$31.09

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.34 changed to 0.35
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $30.74changed to$30.73

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $30.86changed to$30.74

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $30.70changed to$30.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $30.62changed to$30.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $30.01changed to$30.62

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.37 changed to 0.34
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $30.01

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$28.85$21.92RVU26D
2026-07-01$28.85$21.92RVU26C
2026-04-01$28.85$21.92RVU26B
2026-01-01$28.85$21.92RVU26A
2025-10-01$28.12$26.19RVU25D
2025-07-01$28.12$26.19RVU25C
2025-04-01$28.12$26.19RVU25B
2025-01-01$28.12$26.19RVU25A
2024-10-01$28.61$26.96RVU24D
2024-07-01$28.61$26.96RVU24C
2024-04-01$28.61$26.96RVU24B
2024-03-09$28.61$26.96RVU24AR
2024-01-01$28.14$26.52RVU24A
2023-10-01$29.25$27.55RVU23D
2023-07-01$29.25$27.55RVU23C
2023-04-01$29.25$27.55RVU23B
2023-01-01$29.25$27.55RVU23A
2022-10-01$29.65$27.89RVU22D
2022-07-01$29.65$27.89RVU22C
2022-04-01$29.65$27.89RVU22B
2022-01-01$29.65$27.89RVU22A
2021-10-01$29.90$28.12RVU21D
2021-07-01$29.90$28.12RVU21C
2021-04-01$29.90$28.12RVU21B
2021-01-01$29.90$28.12RVU21A
2020-10-01$31.07$29.60RVU20D
2020-07-01$31.07$29.60RVU20C
2020-04-01$31.07$29.60RVU20B
2020-01-01$31.07$29.60RVU20A
2019-10-01$30.75$29.28RVU19D
2019-07-01$30.75$29.28RVU19C
2019-04-01$30.75$29.28RVU19B
2019-01-01$30.75$29.28RVU19A
2018-10-01$31.09$29.25RVU18D
2018-07-01$31.09$29.25RVU18C
2018-04-01$31.09$29.25RVU18B
2018-01-01$31.09$29.25RVU18AR1
2017-10-01$30.73$29.26RVU17D
2017-07-01$30.73$29.26RVU17C
2017-04-01$30.73$29.26RVU17B
2017-01-01$30.73$29.26RVU17A
2016-10-01$30.74$28.90RVU16D
2016-07-01$30.74$28.90RVU16C
2016-04-01$30.74$28.90RVU16B
2016-01-01$30.74$28.90RVU16A
2015-10-01$30.86$29.00RVU15D
2015-07-01$30.86$29.00RVU15C
2015-04-01$30.70$28.86RVU15B
2015-01-01$30.70$28.86RVU15A
2014-10-01$30.62$29.14RVU14D
2014-07-01$30.62$29.14RVU14C
2014-04-01$30.62$29.14RVU14B
2014-01-01$30.62$29.14RVU14A
2013-10-01$30.01$28.24RVU13D
2013-07-01$30.01$28.24RVU13C
2013-04-01$30.01$28.24RVU13B
2013-01-01$30.01$28.24RVU13AR

Price 67225 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

67225 billing questions

Which primary code must accompany this add-on?

Report it with 67221 when photodynamic therapy is performed on the second eye in the same session as primary-eye treatment.

Can this code be reported for treatment on a later date?

No. It represents treatment of the second eye during the same session as the primary procedure, not a later visit.

What documentation supports reporting the second-eye service?

Document the choroidal condition and the treatment performed in each eye, including which eye received the primary procedure and which received the add-on service.

How does CMS treat payment for this code?

CMS identifies it as an add-on that must be billed with a primary procedure; payment is within that procedure's global period.

Is treatment of the second eye reported as another primary procedure?

For same-session treatment of the second eye, report this add-on with the primary photodynamic therapy code rather than reporting a separate primary procedure.

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 67225PPRRVU2026_Oct_nonQPP.csv, line 7,446 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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