CPT code 67516: Eye injection, suprachoroidal route2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $136.40 for 67516 in the office and $87.61 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 67516 nationwide

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

What 67516 covers

An ophthalmologist, often a retina specialist, uses a specialized injection technique to deliver medication into the space between the choroid and sclera. A typical clinical use is treatment of macular edema associated with uveitis. The code identifies the suprachoroidal route; injections into the vitreous, subconjunctival tissue, or orbit are different services.

Document the treated eye, medication, route, and clinical indication, including that the injection entered the suprachoroidal space. The drug may be reported separately when appropriate. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. With multiple procedures in one session, Medicare pays the highest-valued procedure in full and reduces others to 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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.

How Washington, DC area compares for 67516

Across 109 of 109 payment localities, the office rate for 67516 runs from $109.79 in Arkansas to $154.68 in San Benito County, CA. Washington, DC area pays $136.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

67516 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 67516 in every payment locality

How the 67516 rate is calculated

Each of 67516’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.

Payment rules and modifiers for 67516

The CMS indicators that decide how 67516 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

Codes related to 67516

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

How 67516 has changed in Washington, DC area

Price 67516 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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

Open CMS sourceHow we calculate rates