$277.95
Choose 67101 when cryotherapy is the repair method; choose 67105 when the detachment repair uses photocoagulation.
On this page
CMS RVU26D · Effective 2026-10-01
67101 Retinal repair Medicare reimbursement rates in Kentucky
Reports cryotherapy-based repair of an established retinal detachment, including drainage of subretinal fluid when performed. Compare 67101 office and facility rates across CMS payment localities in Kentucky.
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 67101 in Kentucky?
Kentucky 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
$310.99
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$231.41
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Retina surgery
About 67101: Retinal detachment repair with cryotherapy
Reports cryotherapy-based repair of an established retinal detachment, including drainage of subretinal fluid when performed.
An ophthalmologist, often a retina specialist, applies transscleral cryotherapy to retinal breaks associated with an established detachment, creating an adhesion intended to seal the break. Drainage of subretinal fluid is included when performed. This approach differs from treating an isolated retinal tear before detachment and from repairs using a scleral buckle, vitrectomy, or injected gas. It may be performed in an office or surgical facility, depending on the case and setting.
Report 67101 when the documented repair uses cryotherapy. The operative note should establish the detachment, identify the treated break or breaks, and describe the cryotherapy and any fluid drainage. Related postoperative visits during the 10-day global period are included. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and the others at 50%; bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 67101
- 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 · 34%
- Practice expense (office) RVU6.37 · 63%
- Malpractice RVU0.26 · 3%
263
Medicare services in 2024 · #4096 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.
67101 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
67107 describes repair using a scleral buckle. 67101 is the cryotherapy-based repair approach.
$830.25
67110 is for pneumatic retinopexy using injected gas. 67101 reports cryotherapy-based repair.
$249.55
67141 treats a retinal break prophylactically before detachment; 67101 repairs an established detachment.
Compare 67101 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
Kentucky →
Office / nonfacility
$310.99
Facility
$231.41
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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 67101 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,430
- Code
- 67101
- Physician work
- 3.41
- Practice expense
- 6.37
- Malpractice
- 0.26
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.41 | × 1.000 | 3.4100 |
| Practice expense | 6.37 | × 0.889 | 5.6629 |
| Malpractice | 0.26 | × 0.915 | 0.2379 |
| Total RVUs | 9.3108 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$310.99
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1 |
| Practice expense | 6.37 | 0.889 |
| Malpractice | 0.26 | 0.915 |
(3.41 × 1 + 6.37 × 0.889 + 0.26 × 0.915) × $33.4009 = $310.99
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1 |
| Practice expense | 3.69 | 0.889 |
| Malpractice | 0.26 | 0.915 |
(3.41 × 1 + 3.69 × 0.889 + 0.26 × 0.915) × $33.4009 = $231.41
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.
67101 billing questions
How does 67101 differ from 67105?
Both address an established retinal detachment, but 67101 uses cryotherapy and 67105 uses photocoagulation. The documentation should support the repair method performed.
Can subretinal fluid drainage be billed separately?
No. Drainage of subretinal fluid is included in 67101 when performed.
When is 67101 preferable to 67141?
67101 is for repair of an established retinal detachment. 67141 is used for prophylactic treatment of a retinal break when the goal is to prevent detachment.
How are bilateral services and multiple procedures handled?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
Are postoperative visits included?
Related postoperative visits for 10 days are included in the minor-procedure global period.
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.
7,42767041,,Vit for macular pucker,A,,15.92,11.40,NA,11.40,,1.27,28.59,28.59,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42867042,,Vit for macular hole,A,,15.92,11.39,NA,11.39,,1.27,28.58,28.58,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42967043,,Vit for membrane dissect,A,,16.97,11.77,NA,11.77,,1.34,30.08,30.08,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43067101,,Repair detached retina crtx,A,,3.41,6.37,,3.69,,0.26,10.04,7.36,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43167105,,Repair detached retina pc,A,,3.31,5.38,,3.54,,0.25,8.94,7.10,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43267107,,Repair detached retina,A,,15.60,11.28,NA,11.28,,1.25,28.13,28.13,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43367108,,Repair detached retina,A,,16.70,11.67,NA,11.67,,1.33,29.70,29.70,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631