CPT code 67227: Retinopathy treatment2026 Medicare rate & RVUs in Guam
Reports cryotherapy or diathermy to destroy extensive or progressive retinal disease, such as diabetic retinopathy, when that treatment method is used.
Medicare pays $316.78 for 67227 in the office in Guam (Hawaii, Guam). 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 67227 covers
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.
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 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $316.78 | $224.12 |
How the 67227 rate is calculated
Each of 67227’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 · 67227
RVUs × geographic indexes × conversion factor
Work3.41
3.41 RVUs× 1.000 GPCI
Practice expense5.21
5.21 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
8.8800
Conversion factor
$33.4009
Medicare rate
$296.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67227
67227 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67227
Retinopathy treatment
| 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 · 67227
Retinopathy treatment
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
67227 without 50 · national office
$296.60
Retinopathy treatment
67227-50 · Bilateral: 150%
$444.90
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).
67227 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67228Retinal laser
- Use 67227 for extensive or progressive retinopathy treated with cryotherapy or diathermy. Use 67228 when photocoagulation is the treatment method.
- 67208Retinal treatment
- This code concerns extensive or progressive retinopathy treated with cryotherapy or diathermy; 67208 is for treatment of a retinal lesion with those methods.
- 67229Retinopathy treatment
- Code 67229 is specific to extensive or progressive retinopathy in a premature infant. Code 67227 is not the infant-specific retinopathy code.
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 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
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