Billing code 67210: Retinal laserMedicare rate & RVUs in Guam

Reports ophthalmic photocoagulation to destroy a localized retinal lesion, such as macular edema or a retinal tumor, in one or more sessions.

CMS RVU26DEffective Oct 1, 20261 payment locality31K Medicare services in 2024

Medicare pays $550.76 for 67210 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.

$550.76Office (non-facility)
$449.36Hospital or facility

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

We’ll open 67210 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Guam
  2. What 67210 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 67210 covers

billing code 67210 covers laser photocoagulation directed at a localized retinal lesion, including treatment for macular edema or a retinal tumor. An ophthalmologist, often a retina specialist, applies laser energy to the affected retinal area in an office or surgical setting. The code is specific to retinal tissue and photocoagulation; it is not the code for cryotherapy or treatment of a choroidal lesion.

Report the service based on the documented lesion, treated eye, and photocoagulation performed. The code encompasses one or more treatment sessions; document the clinical indication and treated retinal area. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with 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.

67210 in Hawaii, Guam

67210 office and facility rates by payment locality
Payment localityOfficeFacility
Hawaii, Guam$550.76$449.36

How the 67210 rate is calculated

Each of 67210’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 · 67210

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.20Practice expense 8.80Malpractice 0.49

15.4900 adjusted RVUs×$33.4009 conversion factor=$517.38

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 67210

67210 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67210

Retinal laser

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67210

Retinal laser

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67210 without 50 · national office

$517.38

Retinal laser

67210-50 · Bilateral: 150%

$776.07

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).

When to use modifier 50

67210 compared with similar codes

Compare codes

67210 vs 67208 vs 67218 vs 67220 vs 67228: national Medicare rates

Swap in your local Medicare rate.

  • 67210
    Retinal laser · 6.2 wRVU
    $517.38
  • 67208
    Retinal treatment · 7.46 wRVU
    $604.89+$87.51
  • 67218
    Retinal treatment · 19.85 wRVU
    —
  • 67220
    Choroidal lesion treatment · 6.2 wRVU
    $532.08+$14.70
  • 67228
    Retinal laser · 4.28 wRVU
    $341.02−$176.36

How to choose

67208Retinal treatment
Choose 67210 for photocoagulation of a localized retinal lesion. Choose 67208 when the lesion is treated by cryotherapy or diathermy.
67218Retinal treatment
Both address localized retinal lesions, but 67218 is for treatment by radiation therapy rather than photocoagulation.
67220Choroidal lesion treatment
67210 treats a localized retinal lesion with photocoagulation; 67220 is for a localized lesion in the choroid.
67228Retinal laser
67210 is for a localized retinal lesion. 67228 is used for photocoagulation of extensive retinopathy.

67210 billing questions

How does 67210 differ from 67208?

67210 is for photocoagulation of a localized retinal lesion. 67208 is used when the retinal lesion is treated with cryotherapy or diathermy.

Does 67210 include multiple laser spots or sessions?

The code covers one or more treatment sessions for the localized lesion. Document the treated area and service rather than reporting each laser spot as a separate unit.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral treatment reported under the CMS payment rule?

When the service is performed bilaterally and reported with modifier 50, CMS pays 150%.

Can an assistant surgeon or co-surgeon be reported?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

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
RVUs for 67210PPRRVU2026_Oct_nonQPP.csv, line 7,442 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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