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

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 Manhattan, NY, Medicare pays $32.83 for 67225 in the office and $24.68 when it’s performed in a hospital or facility.

$32.83Office (non-facility)
$24.68Hospital or facility
+13.0%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 Manhattan, NY
  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 Manhattan, NY 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. Manhattan, NY pays $32.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

67225 in Manhattan, NY vs other payment areas
  1. Manhattan, NY · this page$32.83
  2. NYC suburbs and Long Island, NY · New York$33.52+$0.69
  3. Poughkeepsie and northern NYC suburbs, NY · New York$31.20−$1.63
  4. Queens, NY · New York$32.88+$0.05
  5. Rest of New York · New York$28.04−$4.79
  6. Los Angeles, CA · California$31.50−$1.33
  7. Washington, DC area · District of Columbia$32.24−$0.59

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

Every other payment area

67225 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$31.61$24.31
Chicago, ILIllinois$30.96$23.91
AlaskaAlaska$36.94$29.47
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

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 Manhattan, NY 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

78

Locality
Manhattan, NY
Physician work
1.064
Practice expense
1.162
Malpractice
1.586
Office calculation for 67225 in Manhattan, NY
ComponentRVULocality factorAdjusted
Physician work0.46× 1.0640.4894
Practice expense0.37× 1.1620.4299
Malpractice0.04× 1.5860.0634
Total RVUs0.9828
Conversion factor× 33.4009

Office rate, Manhattan, NY$32.83

Office: (0.46 × 1.064 + 0.37 × 1.162 + 0.04 × 1.586) × $33.4009 = $32.83

Facility: (0.46 × 1.064 + 0.16 × 1.162 + 0.04 × 1.586) × $33.4009 = $24.68

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, Manhattan, NY
Add-on codes
67221Photodynamic therapy, choroidal lesionPrimary photodynamic therapy procedure to report with this same-session second-eye add-on.$322.97
Used instead
67220Choroidal lesion treatment, laser photocoagulationChoroidal lesion treatment by photocoagulation rather than photodynamic therapy.$604.78
67210Retinal laser, localized lesion photocoagulationPhotocoagulation for a localized retinal lesion, rather than photodynamic treatment of a choroidal lesion.$587.84

How 67225 has changed in Manhattan, NY

67225 · Office / nonfacility

$32.83

Effective 2026-10-01

The base rate is $0.92 higher than on 2025-10-01, moving from $31.91 to $32.83 (2.9%).

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

    $31.91changed to$32.83

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.166 changed to 1.162
    • Malpractice GPCI 1.656 changed to 1.586

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.45changed to$31.91

    • 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

    $31.92changed to$32.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $33.44changed to$31.92

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.184 changed to 1.166
    • Malpractice GPCI 1.843 changed to 1.656

  5. January 1, 2023

    RVU23A

    $34.14changed to$33.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.34 changed to 0.35
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.203 changed to 1.184
    • Malpractice GPCI 2.031 changed to 1.843

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $34.42changed to$34.14

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $35.36changed to$34.42

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.192 changed to 1.203
    • Malpractice GPCI 1.823 changed to 2.031

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $34.02changed to$35.36

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.180 changed to 1.192
    • Malpractice GPCI 1.615 changed to 1.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $34.41changed to$34.02

    • 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

    $33.89changed to$34.41

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.34 changed to 0.35
    • Practice expense GPCI 1.174 changed to 1.180
    • Malpractice GPCI 1.690 changed to 1.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $33.82changed to$33.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.168 changed to 1.174
    • Malpractice GPCI 1.764 changed to 1.690

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $33.94changed to$33.82

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $33.77changed to$33.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $33.62changed to$33.77

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.165 changed to 1.168
    • Malpractice GPCI 1.518 changed to 1.764

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $32.91changed to$33.62

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.37 changed to 0.34
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.162 changed to 1.165
    • Malpractice GPCI 1.271 changed to 1.518

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $32.91

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$32.83$24.68RVU26D
2026-07-01$32.83$24.68RVU26C
2026-04-01$32.83$24.68RVU26B
2026-01-01$32.83$24.68RVU26A
2025-10-01$31.91$29.65RVU25D
2025-07-01$31.91$29.65RVU25C
2025-04-01$31.91$29.65RVU25B
2025-01-01$31.91$29.65RVU25A
2024-10-01$32.45$30.51RVU24D
2024-07-01$32.45$30.51RVU24C
2024-04-01$32.45$30.51RVU24B
2024-03-09$32.45$30.51RVU24AR
2024-01-01$31.92$30.01RVU24A
2023-10-01$33.44$31.43RVU23D
2023-07-01$33.44$31.43RVU23C
2023-04-01$33.44$31.43RVU23B
2023-01-01$33.44$31.43RVU23A
2022-10-01$34.14$32.06RVU22D
2022-07-01$34.14$32.06RVU22C
2022-04-01$34.14$32.06RVU22B
2022-01-01$34.14$32.06RVU22A
2021-10-01$34.42$32.33RVU21D
2021-07-01$34.42$32.33RVU21C
2021-04-01$34.42$32.33RVU21B
2021-01-01$34.42$32.33RVU21A
2020-10-01$35.36$33.64RVU20D
2020-07-01$35.36$33.64RVU20C
2020-04-01$35.36$33.64RVU20B
2020-01-01$35.36$33.64RVU20A
2019-10-01$34.02$32.32RVU19D
2019-07-01$34.02$32.32RVU19C
2019-04-01$34.02$32.32RVU19B
2019-01-01$34.02$32.32RVU19A
2018-10-01$34.41$32.29RVU18D
2018-07-01$34.41$32.29RVU18C
2018-04-01$34.41$32.29RVU18B
2018-01-01$34.41$32.29RVU18AR1
2017-10-01$33.89$32.20RVU17D
2017-07-01$33.89$32.20RVU17C
2017-04-01$33.89$32.20RVU17B
2017-01-01$33.89$32.20RVU17A
2016-10-01$33.82$31.73RVU16D
2016-07-01$33.82$31.73RVU16C
2016-04-01$33.82$31.73RVU16B
2016-01-01$33.82$31.73RVU16A
2015-10-01$33.94$31.84RVU15D
2015-07-01$33.94$31.84RVU15C
2015-04-01$33.77$31.68RVU15B
2015-01-01$33.77$31.68RVU15A
2014-10-01$33.62$31.95RVU14D
2014-07-01$33.62$31.95RVU14C
2014-04-01$33.62$31.95RVU14B
2014-01-01$33.62$31.95RVU14A
2013-10-01$32.91$30.93RVU13D
2013-07-01$32.91$30.93RVU13C
2013-04-01$32.91$30.93RVU13B
2013-01-01$32.91$30.93RVU13AR

Price 67225 for an earlier date of service

Where the Manhattan, NY rate applies

Manhattan, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Manhattan, NYGPCI2026.csv, line 78 (RVU26D)

Open CMS sourceHow we calculate rates

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