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CMS RVU26D · Effective 2026-10-01

67227 Retinopathy treatment Medicare reimbursement rates in Michigan

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 Michigan.

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 Michigan?

Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$282.58–$296.47

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $13.89 per service.

Facility setting

$208.17–$217.82

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $9.65 per service.

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.

Find 67227 in your payment locality →

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 Michigan, from the same CMS release.

67228

Retinal laser

Extensive or progressive retinopathy

$326.32–$342.52

Use 67227 for extensive or progressive retinopathy treated with cryotherapy or diathermy. Use 67228 when photocoagulation is the treatment method.

67208

Retinal treatment

Cryotherapy

$578.20–$606.65

This code concerns extensive or progressive retinopathy treated with cryotherapy or diathermy; 67208 is for treatment of a retinal lesion with those methods.

67229

Retinopathy treatment

Preterm infant, general anesthesia

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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 67227PPRRVU2026_Oct_nonQPP.csv, line 7,447 (RVU26D)