CPT code 67225: Photodynamic therapy, second eye, same session2026 Medicare rate & RVUs in North Carolina
Reports photodynamic treatment of the fellow eye during the same session as primary-eye therapy for a choroidal lesion, billed as an add-on.
In North Carolina, Medicare pays $27.75 for 67225 in the office and $21.20 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Carolina 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. North Carolina pays $27.75. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$27.75
- Los Angeles, CA · California$31.50+$3.75
- Washington, DC area · District of Columbia$32.24+$4.49
- Miami, FL · Florida$31.61+$3.86
- Chicago, IL · Illinois$30.96+$3.21
- Manhattan, NY · New York$32.83+$5.08
- Alaska · Alaska$36.94+$9.19
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $29.89 | $22.20 |
| Merced, CACalifornia | $29.89 | $22.20 |
| Modesto, CACalifornia | $29.89 | $22.20 |
| Napa, CACalifornia | $33.30 | $24.05 |
| Oxnard, CACalifornia | $31.23 | $22.94 |
| Redding, CACalifornia | $29.89 | $22.20 |
| Rest of CaliforniaCalifornia | $29.89 | $22.20 |
| Riverside, CACalifornia | $30.33 | $22.64 |
| Sacramento, CACalifornia | $31.01 | $22.85 |
| Salinas, CACalifornia | $30.88 | $22.75 |
| San Diego, CACalifornia | $31.33 | $22.94 |
| Marin County, CACalifornia | $34.86 | $24.97 |
| San Francisco, CACalifornia | $34.82 | $24.93 |
| San Benito County, CACalifornia | $35.59 | $25.48 |
| Santa Clara County, CACalifornia | $35.41 | $25.29 |
| San Luis Obispo, CACalifornia | $30.42 | $22.43 |
| Santa Cruz, CACalifornia | $31.42 | $22.90 |
| Santa Maria, CACalifornia | $30.92 | $22.74 |
| Santa Rosa, CACalifornia | $31.72 | $23.10 |
| Stockton, CACalifornia | $29.89 | $22.20 |
| Vallejo, CACalifornia | $33.23 | $23.99 |
| Visalia, CACalifornia | $29.89 | $22.20 |
| Yuba City, CACalifornia | $29.89 | $22.20 |
| ColoradoColorado | $29.74 | $22.28 |
| ConnecticutConnecticut | $30.60 | $23.04 |
| DelawareDelaware | $28.85 | $21.92 |
| Fort Lauderdale, FLFlorida | $30.30 | $23.19 |
| Rest of FloridaFlorida | $29.19 | $22.48 |
| Atlanta, GAGeorgia | $29.57 | $22.44 |
| Rest of GeorgiaGeorgia | $27.98 | $21.72 |
| Hawaii, Guam, HIHawaii | $30.19 | $22.21 |
| IowaIowa | $27.20 | $20.78 |
| IdahoIdaho | $27.37 | $20.91 |
| East St. Louis, ILIllinois | $29.42 | $22.97 |
| Rest of IllinoisIllinois | $28.74 | $22.33 |
| Suburban Chicago, ILIllinois | $30.53 | $23.33 |
| IndianaIndiana | $27.47 | $20.97 |
| KansasKansas | $27.21 | $20.87 |
| KentuckyKentucky | $27.57 | $21.34 |
| New Orleans, LALouisiana | $28.51 | $21.91 |
| Rest of LouisianaLouisiana | $27.58 | $21.37 |
| Metropolitan Boston, MAMassachusetts | $31.94 | $23.56 |
| Rest of MassachusettsMassachusetts | $29.69 | $22.30 |
| Baltimore area, MDMaryland | $30.52 | $23.00 |
| Rest of MarylandMaryland | $29.25 | $22.15 |
| Rest of MaineMaine | $27.57 | $21.11 |
| Southern Maine, MEMaine | $28.45 | $21.50 |
| Detroit, MIMichigan | $29.54 | $22.77 |
| Rest of MichiganMichigan | $28.16 | $21.75 |
| MinnesotaMinnesota | $28.48 | $21.26 |
| Metropolitan Kansas City, MOMissouri | $28.27 | $21.69 |
| Metropolitan St. Louis, MOMissouri | $28.47 | $21.79 |
| Rest of MissouriMissouri | $27.32 | $21.27 |
| MississippiMississippi | $26.99 | $20.95 |
| MontanaMontana | $29.06 | $22.04 |
| North DakotaNorth Dakota | $28.27 | $21.25 |
| NebraskaNebraska | $27.28 | $20.80 |
| New HampshireNew Hampshire | $29.40 | $22.10 |
| Northern New JerseyNew Jersey | $32.09 | $23.96 |
| Rest of New JerseyNew Jersey | $30.94 | $23.28 |
| New MexicoNew Mexico | $28.30 | $21.87 |
| NevadaNevada | $28.85 | $21.83 |
| NYC suburbs and Long Island, NYNew York | $33.52 | $25.18 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $31.20 | $23.52 |
| Queens, NYNew York | $32.88 | $24.59 |
| Rest of New YorkNew York | $28.04 | $21.38 |
| OhioOhio | $27.99 | $21.59 |
| OklahomaOklahoma | $27.44 | $21.17 |
| Portland, OROregon | $30.33 | $22.54 |
| Rest of OregonOregon | $28.61 | $21.63 |
| Metropolitan Philadelphia, PAPennsylvania | $30.10 | $22.80 |
| Rest of PennsylvaniaPennsylvania | $27.97 | $21.53 |
| Puerto RicoPuerto Rico | $29.17 | $22.08 |
| Rhode IslandRhode Island | $29.61 | $22.37 |
| South CarolinaSouth Carolina | $27.92 | $21.44 |
| South DakotaSouth Dakota | $28.17 | $21.16 |
| TennesseeTennessee | $27.32 | $20.94 |
| Austin, TXTexas | $29.65 | $22.23 |
| Beaumont, TXTexas | $27.85 | $21.47 |
| Brazoria, TXTexas | $28.78 | $21.83 |
| Dallas, TXTexas | $28.96 | $21.97 |
| Fort Worth, TXTexas | $28.85 | $21.94 |
| Galveston, TXTexas | $28.87 | $21.90 |
| Houston, TXTexas | $29.60 | $22.63 |
| Rest of TexasTexas | $28.30 | $21.64 |
| UtahUtah | $28.18 | $21.59 |
| VirginiaVirginia | $28.46 | $21.56 |
| Virgin Islands, VIUnited States Virgin Islands | $29.17 | $22.08 |
| VermontVermont | $28.28 | $21.33 |
| Rest of WashingtonWashington | $29.59 | $22.21 |
| King County, WAWashington | $32.39 | $23.78 |
| WisconsinWisconsin | $27.62 | $20.90 |
| West VirginiaWest Virginia | $28.02 | $21.92 |
| WyomingWyoming | $28.71 | $21.70 |
67225 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.
$26.67
$36.94
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $36.94 | 1 |
| AL | $26.93 | 1 |
| AR | $26.67 | 1 |
| AZ | $28.48 | 1 |
| CA | $29.89–$35.59 | 29 |
| CO | $29.74 | 1 |
| CT | $30.60 | 1 |
| DC | $32.24 | 1 |
| DE | $28.85 | 1 |
| FL | $29.19–$31.61 | 3 |
| GA | $27.98–$29.57 | 2 |
| GU | $30.19 | 1 |
| HI | $30.19 | 1 |
| IA | $27.20 | 1 |
| ID | $27.37 | 1 |
| IL | $28.74–$30.96 | 4 |
| IN | $27.47 | 1 |
| KS | $27.21 | 1 |
| KY | $27.57 | 1 |
| LA | $27.58–$28.51 | 2 |
| MA | $29.69–$31.94 | 2 |
| MD | $29.25–$32.24 | 3 |
| ME | $27.57–$28.45 | 2 |
| MI | $28.16–$29.54 | 2 |
| MN | $28.48 | 1 |
| MO | $27.32–$28.47 | 3 |
| MS | $26.99 | 1 |
| MT | $29.06 | 1 |
| NC | $27.75 | 1 |
| ND | $28.27 | 1 |
| NE | $27.28 | 1 |
| NH | $29.40 | 1 |
| NJ | $30.94–$32.09 | 2 |
| NM | $28.30 | 1 |
| NV | $28.85 | 1 |
| NY | $28.04–$33.52 | 5 |
| OH | $27.99 | 1 |
| OK | $27.44 | 1 |
| OR | $28.61–$30.33 | 2 |
| PA | $27.97–$30.10 | 2 |
| PR | $29.17 | 1 |
| RI | $29.61 | 1 |
| SC | $27.92 | 1 |
| SD | $28.17 | 1 |
| TN | $27.32 | 1 |
| TX | $27.85–$29.65 | 8 |
| UT | $28.18 | 1 |
| VA | $28.46–$32.24 | 2 |
| VI | $29.17 | 1 |
| VT | $28.28 | 1 |
| WA | $29.59–$32.39 | 2 |
| WI | $27.62 | 1 |
| WV | $28.02 | 1 |
| WY | $28.71 | 1 |
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
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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.46 | × 1.000 | 0.4600 |
| Practice expense | 0.37 | × 0.933 | 0.3452 |
| Malpractice | 0.04 | × 0.639 | 0.0256 |
| Total RVUs | 0.8308 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$27.75
Office: (0.46 × 1 + 0.37 × 0.933 + 0.04 × 0.639) × $33.4009 = $27.75
Facility: (0.46 × 1 + 0.16 × 0.933 + 0.04 × 0.639) × $33.4009 = $21.20
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
How 67225 has changed in North Carolina
67225 · Office / nonfacility
$27.75
Effective 2026-10-01
The base rate is $0.90 higher than on 2025-10-01, moving from $26.85 to $27.75 (3.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$26.85changed to$27.75
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$27.32changed to$26.85
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.35 changed to 0.36
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$26.87changed to$27.32
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$27.93changed to$26.87
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$28.32changed to$27.93
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.34 changed to 0.35
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$28.55changed to$28.32
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$29.40changed to$28.55
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$29.10changed to$29.40
- 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
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$29.40changed to$29.10
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.35 changed to 0.34
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$29.02changed to$29.40
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.34 changed to 0.35
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$28.97changed to$29.02
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$29.08changed to$28.97
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$28.93changed to$29.08
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$28.94changed to$28.93
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$28.37changed to$28.94
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.37 changed to 0.34
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $28.37
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $27.75 | $21.20 | RVU26D |
| 2026-07-01 | $27.75 | $21.20 | RVU26C |
| 2026-04-01 | $27.75 | $21.20 | RVU26B |
| 2026-01-01 | $27.75 | $21.20 | RVU26A |
| 2025-10-01 | $26.85 | $25.05 | RVU25D |
| 2025-07-01 | $26.85 | $25.05 | RVU25C |
| 2025-04-01 | $26.85 | $25.05 | RVU25B |
| 2025-01-01 | $26.85 | $25.05 | RVU25A |
| 2024-10-01 | $27.32 | $25.78 | RVU24D |
| 2024-07-01 | $27.32 | $25.78 | RVU24C |
| 2024-04-01 | $27.32 | $25.78 | RVU24B |
| 2024-03-09 | $27.32 | $25.78 | RVU24AR |
| 2024-01-01 | $26.87 | $25.36 | RVU24A |
| 2023-10-01 | $27.93 | $26.36 | RVU23D |
| 2023-07-01 | $27.93 | $26.36 | RVU23C |
| 2023-04-01 | $27.93 | $26.36 | RVU23B |
| 2023-01-01 | $27.93 | $26.36 | RVU23A |
| 2022-10-01 | $28.32 | $26.71 | RVU22D |
| 2022-07-01 | $28.32 | $26.71 | RVU22C |
| 2022-04-01 | $28.32 | $26.71 | RVU22B |
| 2022-01-01 | $28.32 | $26.71 | RVU22A |
| 2021-10-01 | $28.55 | $26.93 | RVU21D |
| 2021-07-01 | $28.55 | $26.93 | RVU21C |
| 2021-04-01 | $28.55 | $26.93 | RVU21B |
| 2021-01-01 | $28.55 | $26.93 | RVU21A |
| 2020-10-01 | $29.40 | $28.06 | RVU20D |
| 2020-07-01 | $29.40 | $28.06 | RVU20C |
| 2020-04-01 | $29.40 | $28.06 | RVU20B |
| 2020-01-01 | $29.40 | $28.06 | RVU20A |
| 2019-10-01 | $29.10 | $27.76 | RVU19D |
| 2019-07-01 | $29.10 | $27.76 | RVU19C |
| 2019-04-01 | $29.10 | $27.76 | RVU19B |
| 2019-01-01 | $29.10 | $27.76 | RVU19A |
| 2018-10-01 | $29.40 | $27.73 | RVU18D |
| 2018-07-01 | $29.40 | $27.73 | RVU18C |
| 2018-04-01 | $29.40 | $27.73 | RVU18B |
| 2018-01-01 | $29.40 | $27.73 | RVU18AR1 |
| 2017-10-01 | $29.02 | $27.68 | RVU17D |
| 2017-07-01 | $29.02 | $27.68 | RVU17C |
| 2017-04-01 | $29.02 | $27.68 | RVU17B |
| 2017-01-01 | $29.02 | $27.68 | RVU17A |
| 2016-10-01 | $28.97 | $27.31 | RVU16D |
| 2016-07-01 | $28.97 | $27.31 | RVU16C |
| 2016-04-01 | $28.97 | $27.31 | RVU16B |
| 2016-01-01 | $28.97 | $27.31 | RVU16A |
| 2015-10-01 | $29.08 | $27.41 | RVU15D |
| 2015-07-01 | $29.08 | $27.41 | RVU15C |
| 2015-04-01 | $28.93 | $27.27 | RVU15B |
| 2015-01-01 | $28.93 | $27.27 | RVU15A |
| 2014-10-01 | $28.94 | $27.61 | RVU14D |
| 2014-07-01 | $28.94 | $27.61 | RVU14C |
| 2014-04-01 | $28.94 | $27.61 | RVU14B |
| 2014-01-01 | $28.94 | $27.61 | RVU14A |
| 2013-10-01 | $28.37 | $26.79 | RVU13D |
| 2013-07-01 | $28.37 | $26.79 | RVU13C |
| 2013-04-01 | $28.37 | $26.79 | RVU13B |
| 2013-01-01 | $28.37 | $26.79 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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