Billing code 67228: Retinal laserMedicare rate & RVUs in Florida
Reports retinal laser treatment for extensive or progressive retinopathy, commonly proliferative diabetic retinopathy, including treatment delivered over one or more sessions.
Medicare pays $338.70–$366.54 for 67228 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$338.70 to $366.54
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $352.89 | $264.58 |
| Miami | $366.54 | $275.79 |
| Rest Of Florida | $338.70 | $255.36 |
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
Swap in your local Medicare rate.
Work 4.28Practice expense 5.58Malpractice 0.35
All indexes start 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67228
Retinal laser
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.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67228 without 50 · national office
$341.02
Retinal laser
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).
67228 compared with similar codes
Compare codes
67228 vs 67227 vs 67210 vs 67208: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67227Retinopathy treatment
- Both address extensive or progressive retinopathy, but 67227 uses cryotherapy; this code is for photocoagulation.
- 67210Retinal laser
- Use 67210 for photocoagulation of a localized retinal lesion. This code is for extensive or progressive retinopathy.
- 67208Retinal treatment
- 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
Fee sheets
Put 67228 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →