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CMS RVU26D · Effective 2026-10-01

67227 in Modesto

Office / nonfacility

$311.21

Base rate per service

Facility setting

$221.89

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Ophthalmology

About 67227: Extensive retinopathy destruction by cryotherapy

Reports cryotherapy or diathermy to destroy extensive or progressive retinal disease, such as diabetic retinopathy, when that treatment method is used.

An ophthalmologist, often a retina specialist, uses cryotherapy or diathermy to treat extensive or progressive retinopathy. A typical clinical context is widespread diabetic retinal disease requiring destructive treatment rather than treatment of a single discrete retinal lesion. The service may be performed in an office-based or facility setting, depending on the care provided.

Choose this code based on the disease extent and the destructive method documented; laser photocoagulation for extensive retinopathy is represented by a separate code. The record should identify the treated eye, the retinopathy and its extent or progression, and the method used. CMS assigns a 10-day global period, so related postoperative visits during those 10 days are included. For bilateral treatment reported with modifier 50, CMS pays 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 67227

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.41 · 38%
  • Practice expense (office) RVU5.21 · 59%
  • Malpractice RVU0.26 · 3%

52

Medicare services in 2024 · #5337 by national volume

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.

67227 compared with similar codes

Office rates for Modesto, from the same CMS release.

67228

Retinal laser

Extensive or progressive retinopathy

$355.92

Use 67227 for extensive or progressive retinopathy treated with cryotherapy or diathermy. Use 67228 when photocoagulation is the treatment method.

67208

Retinal treatment

Cryotherapy

$632.24

This code concerns extensive or progressive retinopathy treated with cryotherapy or diathermy; 67208 is for treatment of a retinal lesion with those methods.

67229

Retinopathy treatment

Preterm infant, general anesthesia

No office rate

Code 67229 is specific to extensive or progressive retinopathy in a premature infant. Code 67227 is not the infant-specific retinopathy code.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 67227 is $312.07—$0.86 higher than the $311.21 rate in Modesto. Both use the same code, release and participation basis.

67227 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $311.21

  2. Bakersfield

    $312.07

    $0.86 higher than Modesto

  3. Chico

    $311.21

    The same base rate than Modesto

  4. El Centro

    $311.26

    $0.05 higher than Modesto

  5. Fresno

    $311.21

    The same base rate than Modesto

  6. Hanford-Corcoran

    $311.21

    The same base rate than Modesto

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $330.20

    $18.99 higher than Modesto

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 67227 ranges from $267.85 in Arkansas to $382.02 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Merced

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Napa

    California · 67227

    Office

    $354.84

    Facility

    $247.43

    $43.63 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 67227

    Office

    $328.19

    Facility

    $231.86

    $16.98 higher than Modesto for the office setting.

  • Redding

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 67227

    Office

    $314.08

    Facility

    $224.76

    $2.87 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 67227

    Office

    $325.04

    Facility

    $230.25

    $13.83 higher than Modesto for the office setting.

  • Salinas

    California · 67227

    Office

    $323.77

    Facility

    $229.31

    $12.56 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 67227

    Office

    $330.15

    Facility

    $232.68

    $18.94 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 67227

    Office

    $374.07

    Facility

    $259.16

    $62.86 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 67227

    Office

    $373.77

    Facility

    $258.86

    $62.56 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 67227

    Office

    $382.02

    Facility

    $264.50

    $70.81 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 67227

    Office

    $380.81

    Facility

    $263.29

    $69.60 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 67227

    Office

    $318.70

    Facility

    $225.87

    $7.49 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 67227

    Office

    $332.38

    Facility

    $233.36

    $21.17 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 67227

    Office

    $324.65

    Facility

    $229.62

    $13.44 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 67227

    Office

    $335.66

    Facility

    $235.58

    $24.45 higher than Modesto for the office setting.

  • Stockton

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 67227

    Office

    $354.42

    Facility

    $247.00

    $43.21 higher than Modesto for the office setting.

  • Visalia

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 67227

    Office

    $311.21

    Facility

    $221.89

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 67227

    Office

    $334.71

    Facility

    $238.70

    $23.50 higher than Modesto for the office setting.

  • Miami

    Florida · 67227

    Office

    $317.01

    Facility

    $232.17

    $5.80 higher than Modesto for the office setting.

  • Chicago

    Illinois · 67227

    Office

    $309.51

    Facility

    $227.61

    $1.70 lower than Modesto for the office setting.

  • Manhattan

    New York · 67227

    Office

    $337.17

    Facility

    $242.47

    $25.96 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 67227

    Office

    $360.96

    Facility

    $274.16

    $49.75 higher than Modesto for the office setting.

  • Alabama

    Alabama · 67227

    Office

    $271.08

    Facility

    $199.77

    $40.13 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 67227

    Office

    $267.85

    Facility

    $197.84

    $43.36 lower than Modesto for the office setting.

  • Arizona

    Arizona · 67227

    Office

    $289.95

    Facility

    $210.98

    $21.26 lower than Modesto for the office setting.

  • Colorado

    Colorado · 67227

    Office

    $307.20

    Facility

    $220.49

    $4.01 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 67227

    Office

    $314.10

    Facility

    $226.33

    $2.89 higher than Modesto for the office setting.

  • Delaware

    Delaware · 67227

    Office

    $294.20

    Facility

    $213.68

    $17.01 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 67227

    Office

    $305.88

    Facility

    $223.32

    $5.33 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 67227

    Office

    $293.31

    Facility

    $215.40

    $17.90 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 67227

    Office

    $301.47

    Facility

    $218.67

    $9.74 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 67227

    Office

    $279.47

    Facility

    $206.78

    $31.74 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 67227

    Office

    $316.78

    Facility

    $224.12

    $5.57 higher than Modesto for the office setting.

  • Iowa

    Iowa · 67227

    Office

    $276.57

    Facility

    $202.00

    $34.64 lower than Modesto for the office setting.

  • Idaho

    Idaho · 67227

    Office

    $278.10

    Facility

    $203.12

    $33.11 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 67227

    Office

    $291.48

    Facility

    $216.51

    $19.73 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 67227

    Office

    $286.35

    Facility

    $211.94

    $24.86 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 67227

    Office

    $308.80

    Facility

    $225.10

    $2.41 lower than Modesto for the office setting.

  • Indiana

    Indiana · 67227

    Office

    $279.43

    Facility

    $203.88

    $31.78 lower than Modesto for the office setting.

  • Kansas

    Kansas · 67227

    Office

    $275.59

    Facility

    $201.91

    $35.62 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 67227

    Office

    $276.55

    Facility

    $204.09

    $34.66 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 67227

    Office

    $287.51

    Facility

    $210.82

    $23.70 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 67227

    Office

    $276.22

    Facility

    $204.10

    $34.99 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 67227

    Office

    $334.07

    Facility

    $236.77

    $22.86 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 67227

    Office

    $305.88

    Facility

    $220.06

    $5.33 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 67227

    Office

    $313.18

    Facility

    $225.74

    $1.97 higher than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 67227

    Office

    $299.12

    Facility

    $216.64

    $12.09 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 67227

    Office

    $279.40

    Facility

    $204.42

    $31.81 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 67227

    Office

    $291.83

    Facility

    $211.06

    $19.38 lower than Modesto for the office setting.

  • Detroit

    Michigan · 67227

    Office

    $296.47

    Facility

    $217.82

    $14.74 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 67227

    Office

    $282.58

    Facility

    $208.17

    $28.63 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 67227

    Office

    $295.53

    Facility

    $211.67

    $15.68 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 67227

    Office

    $285.79

    Facility

    $209.26

    $25.42 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 67227

    Office

    $288.26

    Facility

    $210.68

    $22.95 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 67227

    Office

    $272.36

    Facility

    $202.11

    $38.85 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 67227

    Office

    $270.14

    Facility

    $199.97

    $41.07 lower than Modesto for the office setting.

  • Montana**

    Montana · 67227

    Office

    $296.58

    Facility

    $215.08

    $14.63 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 67227

    Office

    $281.81

    Facility

    $205.77

    $29.40 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 67227

    Office

    $291.44

    Facility

    $209.94

    $19.77 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 67227

    Office

    $277.80

    Facility

    $202.58

    $33.41 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 67227

    Office

    $302.65

    Facility

    $217.81

    $8.56 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 67227

    Office

    $332.21

    Facility

    $237.67

    $21.00 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 67227

    Office

    $318.01

    Facility

    $229.01

    $6.80 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 67227

    Office

    $283.90

    Facility

    $209.17

    $27.31 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 67227

    Office

    $295.32

    Facility

    $213.74

    $15.89 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 67227

    Office

    $344.22

    Facility

    $247.32

    $33.01 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 67227

    Office

    $320.08

    Facility

    $230.84

    $8.87 higher than Modesto for the office setting.

  • Queens

    New York · 67227

    Office

    $339.40

    Facility

    $243.07

    $28.19 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 67227

    Office

    $285.32

    Facility

    $207.90

    $25.89 lower than Modesto for the office setting.

  • Ohio

    Ohio · 67227

    Office

    $281.53

    Facility

    $207.12

    $29.68 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 67227

    Office

    $276.04

    Facility

    $203.27

    $35.17 lower than Modesto for the office setting.

  • Portland

    Oregon · 67227

    Office

    $315.52

    Facility

    $224.97

    $4.31 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 67227

    Office

    $293.32

    Facility

    $212.15

    $17.89 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 67227

    Office

    $307.46

    Facility

    $222.62

    $3.75 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 67227

    Office

    $281.85

    Facility

    $207.04

    $29.36 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 67227

    Office

    $298.38

    Facility

    $215.99

    $12.83 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 67227

    Office

    $303.57

    Facility

    $219.38

    $7.64 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 67227

    Office

    $282.07

    Facility

    $206.77

    $29.14 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 67227

    Office

    $290.83

    Facility

    $209.34

    $20.38 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 67227

    Office

    $276.74

    Facility

    $202.66

    $34.47 lower than Modesto for the office setting.

  • Austin

    Texas · 67227

    Office

    $305.93

    Facility

    $219.71

    $5.28 lower than Modesto for the office setting.

  • Beaumont

    Texas · 67227

    Office

    $280.32

    Facility

    $206.16

    $30.89 lower than Modesto for the office setting.

  • Brazoria

    Texas · 67227

    Office

    $294.03

    Facility

    $213.27

    $17.18 lower than Modesto for the office setting.

  • Dallas

    Texas · 67227

    Office

    $295.70

    Facility

    $214.52

    $15.51 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 67227

    Office

    $294.07

    Facility

    $213.71

    $17.14 lower than Modesto for the office setting.

  • Galveston

    Texas · 67227

    Office

    $294.80

    Facility

    $213.87

    $16.41 lower than Modesto for the office setting.

  • Houston

    Texas · 67227

    Office

    $299.56

    Facility

    $218.63

    $11.65 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 67227

    Office

    $286.88

    Facility

    $209.54

    $24.33 lower than Modesto for the office setting.

  • Utah

    Utah · 67227

    Office

    $285.27

    Facility

    $208.66

    $25.94 lower than Modesto for the office setting.

  • Virginia

    Virginia · 67227

    Office

    $291.09

    Facility

    $210.98

    $20.12 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 67227

    Office

    $298.38

    Facility

    $215.99

    $12.83 lower than Modesto for the office setting.

  • Vermont

    Vermont · 67227

    Office

    $290.57

    Facility

    $209.89

    $20.64 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 67227

    Office

    $305.23

    Facility

    $219.41

    $5.98 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 67227

    Office

    $340.21

    Facility

    $240.21

    $29.00 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 67227

    Office

    $283.28

    Facility

    $205.21

    $27.93 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 67227

    Office

    $277.55

    Facility

    $206.72

    $33.66 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 67227

    Office

    $294.34

    Facility

    $212.84

    $16.87 lower than Modesto for the office setting.

See how rates vary across the country

67227 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$267.85

$360.96

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$360.961
AL$271.081
AR$267.851
AZ$289.951
CA$311.21–$382.0229
CO$307.201
CT$314.101
DC$334.711
DE$294.201
FL$293.31–$317.013
GA$279.47–$301.472
GU$316.781
HI$316.781
IA$276.571
ID$278.101
IL$286.35–$309.514
IN$279.431
KS$275.591
KY$276.551
LA$276.22–$287.512
MA$305.88–$334.072
MD$299.12–$334.713
ME$279.40–$291.832
MI$282.58–$296.472
MN$295.531
MO$272.36–$288.263
MS$270.141
MT$296.581
NC$281.811
ND$291.441
NE$277.801
NH$302.651
NJ$318.01–$332.212
NM$283.901
NV$295.321
NY$285.32–$344.225
OH$281.531
OK$276.041
OR$293.32–$315.522
PA$281.85–$307.462
PR$298.381
RI$303.571
SC$282.071
SD$290.831
TN$276.741
TX$280.32–$305.938
UT$285.271
VA$291.09–$334.712
VI$298.381
VT$290.571
WA$305.23–$340.212
WI$283.281
WV$277.551
WY$294.341

Explore 67227 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 67227 in Modesto, the physician’s office rate is $311.21 and the facility-setting rate is $221.89: a difference of $89.32.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 67227 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$342.33

$311.21 × 110% = $342.33

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 67227 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

7,447

Code
67227
Physician work
3.41
Practice expense
5.21
Malpractice
0.26

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 67227 in Modesto
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0173.4680
Practice expense5.21× 1.0965.7102
Malpractice0.26× 0.5360.1394
Total RVUs9.3175
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$311.21

Open 67227 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.411.017
Practice expense5.211.096
Malpractice0.260.536

(3.41 × 1.017 + 5.21 × 1.096 + 0.26 × 0.536) × $33.4009 = $311.21

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.411.017
Practice expense2.771.096
Malpractice0.260.536

(3.41 × 1.017 + 2.77 × 1.096 + 0.26 × 0.536) × $33.4009 = $221.89

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

67227 · Office / nonfacility

$311.21

Effective 2026-10-01

The base rate is $14.92 higher than on 2025-10-01, moving from $296.29 to $311.21 (5.0%).

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

    $296.29changed to$311.21

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.50 changed to 3.41
    • Practice expense RVU 4.99 changed to 5.21
    • Malpractice RVU 0.28 changed to 0.26
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $296.29

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$311.21$221.89RVU26D
2026-07-01$311.21$221.89RVU26C
2026-04-01$311.21$221.89RVU26B
2026-01-01$311.21$221.89RVU26A
2025-10-01$296.29$253.51RVU25D
2025-07-01$296.29$253.51RVU25C
2025-04-01$296.29$253.51RVU25B
2025-01-01$296.29$253.51RVU25A

67227 billing questions

How does this code differ from 67228?

Both address extensive or progressive retinopathy, but 67227 is for cryotherapy or diathermy. Code 67228 is used when the treatment is photocoagulation.

Can this code be used for a single retinal lesion?

It is intended for extensive or progressive retinopathy, not treatment of a discrete retinal lesion. Codes 67208 and 67210 describe retinal-lesion treatment using different methods.

Are postoperative visits separately reported during the global period?

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

How is bilateral treatment handled?

CMS recognizes this as a bilateral procedure; treatment of both eyes reported with modifier 50 is paid at 150%.

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

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

What documentation supports reporting this code?

Document the diagnosis and extent or progression of the retinopathy, the eye treated, and use of cryotherapy or diathermy.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 67227PPRRVU2026_Oct_nonQPP.csv, line 7,447 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet