Billing code 67145: Laser retinopexyMedicare rate & RVUs

Medicare pays $245.50 for 67145 nationally in the office and $188.72 in a hospital or facility. Local office rates run $220.22–$320.56.

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

What 67145 covers

An ophthalmologist, often a retina specialist, uses focused laser photocoagulation to create an adhesion around a retinal break or selected peripheral retinal lesion judged to put the eye at risk for detachment. The intent is preventive: the service treats the vulnerable area before a retinal detachment requires repair. It is commonly performed in an office with retinal visualization, although facility settings are also used.

Report 67145 for the prophylactic laser treatment session, not for repair of an established detached retina. Documentation should identify the treated eye, break or lesion, why it warrants prophylaxis, and the laser treatment performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 67145 pays more and less

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

109 of 109 payment localities

67145 rates by state

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

How the 67145 rate is calculated

Each of 67145’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 67145

67145 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

67145 compared with similar codes

How to choose

67141Retinal prophylaxis

Choose 67145 for prophylactic laser treatment and 67141 when prophylaxis is performed with cryotherapy.

67105Retinal detachment repair

67105 is for treatment of an established retinal detachment with photocoagulation; 67145 is preventive treatment before detachment.

67101Retinal repair

67101 treats an existing retinal detachment with cryotherapy, while 67145 uses laser for prophylaxis.

Codes related to 67145

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

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