CPT code 67228: Retinal laser, extensive or progressive retinopathy2026 Medicare rate & RVUs

Reports retinal laser treatment for extensive or progressive retinopathy, commonly proliferative diabetic retinopathy, including treatment delivered over one or more sessions.

CMS RVU26DEffective Oct 1, 2026109 payment localities36.2K Medicare services in 2024

Medicare pays $341.02 for 67228 nationally in the office and $253.85 in a hospital or facility. Local office rates run $309.07–$433.70.

Medicare rate · 67228

Retinal laser, extensive or progressive retinopathy

Office or facility?

Work RVUs
4.28
Total RVUs
10.21
Global days
010

National rate · 2026

$341.02

Office setting, before claim adjustments.

See every locality for 67228 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 67228 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 67228 covers

An ophthalmologist uses laser photocoagulation to treat extensive or progressive retinal disease. A common setting is proliferative diabetic retinopathy treated with scatter laser, often called panretinal photocoagulation. The treatment may be delivered over more than one session; the code encompasses one or more sessions rather than describing a single laser spot or isolated retinal lesion. Documentation should identify the treated eye, the retinopathy and its extent or progression, and the laser treatment performed.

Select this service for extensive or progressive retinopathy treated with photocoagulation, not a localized retinal lesion or a different treatment method. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 67228 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$309.07 to $433.70

$309.07$371.38$433.70
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

67228 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$312.65$236.37
Alaska$419.37$326.52
Arizona$333.56$249.09
Arkansas$309.07$234.19
Atlanta, GA$346.78$258.21
Austin, TX$350.79$258.55
Bakersfield, CA$357.06$261.52
Baltimore area, MD$359.69$266.15
Beaumont, TX$323.42$244.09
Brazoria, TX$337.92$251.53

67228 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.

$309.07

$419.37

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

View every state and territory as a table
67228 office rate range by state
State / territoryOffice rate rangeLocalities
AK$419.371
AL$312.651
AR$309.071
AZ$333.561
CA$355.92–$433.7029
CO$352.111
CT$360.691
DC$383.241
DE$338.321
FL$338.70–$366.543
GA$323.14–$346.782
GU$361.641
HI$361.641
IA$318.131
ID$319.951
IL$331.39–$358.094
IN$321.411
KS$317.331
KY$319.341
LA$319.10–$331.622
MA$350.82–$381.762
MD$343.73–$383.243
ME$321.69–$335.032
MI$326.32–$342.522
MN$338.201
MO$315.00–$332.103
MS$312.071
MT$341.001
NC$324.321
ND$334.081
NE$319.401
NH$347.201
NJ$365.02–$380.642
NM$327.901
NV$339.261
NY$328.23–$395.425
OH$324.901
OK$318.471
OR$336.81–$361.012
PA$325.10–$353.492
PR$342.901
RI$348.631
SC$325.101
SD$333.261
TN$318.651
TX$323.42–$350.798
UT$328.651
VA$334.42–$383.242
VI$342.901
VT$333.381
WA$349.97–$388.342
WI$325.111
WV$321.651
WY$337.981

How the 67228 rate is calculated

Each of 67228’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 · 67228

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.28

4.28 RVUs× 1.000 GPCI

Practice expense5.58

5.58 RVUs× 1.000 GPCI

Malpractice0.35

0.35 RVUs× 1.000 GPCI

Adjusted RVUs

10.2100

Conversion factor

$33.4009

Medicare rate

$341.02

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

Payment rules and modifiers for 67228

67228 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67228

Retinal laser, extensive or progressive retinopathy

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 · 67228

Retinal laser, extensive or progressive retinopathy

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

67228 without 50 · national office

$341.02

Retinal laser, extensive or progressive retinopathy

67228-50 · Bilateral: 150%

$511.53

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

67228 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 67228

    Retinal laser, extensive or progressive retinopathy4.28 wRVU

    $341.02

  • 67227

    Retinopathy treatment, cryotherapy or diathermy3.41 wRVU

    $296.60−$44.42

  • 67210

    Retinal laser, localized lesion photocoagulation6.2 wRVU

    $517.38+$176.36

  • 67208

    Retinal treatment, cryotherapy7.46 wRVU

    $604.89+$263.87

How to choose

67227Retinopathy treatmentCryotherapy or diathermy
Both address extensive or progressive retinopathy, but 67227 uses cryotherapy; this code is for photocoagulation.
67210Retinal laserLocalized lesion photocoagulation
Use 67210 for photocoagulation of a localized retinal lesion. This code is for extensive or progressive retinopathy.
67208Retinal treatmentCryotherapy
Code 67208 treats a localized retinal lesion with cryotherapy; this code treats extensive or progressive retinopathy with photocoagulation.

67228 billing questions

When is this code appropriate instead of 67210?

Use this code for laser treatment of extensive or progressive retinopathy, such as proliferative diabetic retinopathy. Code 67210 describes photocoagulation for a localized retinal lesion.

Can the code be reported for each laser session?

The service covers one or more sessions. A series of sessions for the same treatment is not automatically reported as a separate service for every visit.

How should bilateral treatment be reported?

Report modifier 50 for bilateral treatment; Medicare pays the bilateral procedure at 150%.

Are related postoperative visits separately payable?

Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant or co-surgeon be billed?

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

What happens if another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures subject to the standard multiple procedure reduction are paid at 50%.

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 67228PPRRVU2026_Oct_nonQPP.csv, line 7,448 (RVU26D)

Open CMS sourceHow we calculate rates

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