$352.11
Use 67227 for extensive or progressive retinopathy treated with cryotherapy or diathermy. Use 67228 when photocoagulation is the treatment method.
On this page
CMS RVU26D · Effective 2026-10-01
67227 Retinopathy treatment Medicare reimbursement rates in Colorado
Reports cryotherapy or diathermy to destroy extensive or progressive retinal disease, such as diabetic retinopathy, when that treatment method is used. Compare 67227 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 67227 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$307.20
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$220.49
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
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 Colorado, from the same CMS release.
$625.07
This code concerns extensive or progressive retinopathy treated with cryotherapy or diathermy; 67208 is for treatment of a retinal lesion with those methods.
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.
Compare 67227 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$307.20
Facility
$220.49
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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 Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,447
- Code
- 67227
- Physician work
- 3.41
- Practice expense
- 5.21
- Malpractice
- 0.26
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.41 | × 1.012 | 3.4509 |
| Practice expense | 5.21 | × 1.064 | 5.5434 |
| Malpractice | 0.26 | × 0.781 | 0.2031 |
| Total RVUs | 9.1974 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$307.20
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1.012 |
| Practice expense | 5.21 | 1.064 |
| Malpractice | 0.26 | 0.781 |
(3.41 × 1.012 + 5.21 × 1.064 + 0.26 × 0.781) × $33.4009 = $307.20
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1.012 |
| Practice expense | 2.77 | 1.064 |
| Malpractice | 0.26 | 0.781 |
(3.41 × 1.012 + 2.77 × 1.064 + 0.26 × 0.781) × $33.4009 = $220.49
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.
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.
7,44467220,,Treatment of choroid lesion,A,,6.20,9.25,,6.13,,0.48,15.93,12.81,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44567221,,Ocular photodynamic ther,R,,3.36,4.89,,1.42,,0.26,8.51,5.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44667225,,Eye photodynamic ther add-on,A,,0.46,0.37,,0.16,,0.04,0.87,0.66,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44767227,,Dstrj extensive retinopathy,A,,3.41,5.21,,2.77,,0.26,8.88,6.44,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44867228,,Treatment x10sv retinopathy,A,,4.28,5.58,,2.97,,0.35,10.21,7.60,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44967229,,Tr retinal les preterm inf,A,,15.89,11.88,NA,11.88,,1.27,29.04,29.04,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45067250,,Reinforce eye wall,A,,9.37,13.70,NA,13.70,,0.75,23.82,23.82,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899