$558.01–$588.80
Select 67208 for retinal lesion destruction using cryotherapy or diathermy. Select 67218 when radiation is the treatment method.
On this page
CMS RVU26D · Effective 2026-10-01
67218 Retinal treatment Medicare reimbursement rates in Missouri
Reports radiation-based treatment of a localized retinal lesion, such as a tumor, when the ophthalmic surgeon treats the lesion with radiation rather than laser or cryotherapy. Compare 67218 office and facility rates across CMS payment localities in Missouri.
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 67218 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1093.02–$1134.03
3 of 3 localities have a supported rate.
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.
Where 67218 pays more and less in Missouri
Ophthalmology surgery
About 67218: Retinal lesion radiation treatment
Reports radiation-based treatment of a localized retinal lesion, such as a tumor, when the ophthalmic surgeon treats the lesion with radiation rather than laser or cryotherapy.
This service treats a localized retinal lesion with radiation, commonly through plaque brachytherapy for an intraocular tumor. An ophthalmic surgeon performs the procedure in an operating-room setting, positioning the radiation source to deliver treatment to the targeted area. The exact approach depends on the lesion and treatment plan; this code distinguishes radiation treatment from retinal lesion treatment by photocoagulation or cryotherapy.
Report the code when the treated target is in the retina and radiation is the treatment method. The operative record should identify the lesion and its location, the radiation approach, and the treatment performed. The code covers one or more treatment sessions. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67218
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 RVU19.85 · 57%
- Practice expense (office) RVU13.15 · 38%
- Malpractice RVU1.58 · 5%
560
Medicare services in 2024 · #3457 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.
67218 compared with similar codes
Office rates for Missouri, from the same CMS release.
$476.39–$503.30
Select 67210 for retinal lesion treatment by photocoagulation. Radiation-based retinal treatment is reported with 67218.
$489.02–$517.28
67220 concerns a localized lesion of the choroid. Use 67218 for a retinal target treated with radiation.
Compare 67218 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$1127.00
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1134.03
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$1093.02
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67218 billing questions
How does this differ from 67208 or 67210?
Use 67218 when radiation is used to treat the retinal lesion. Codes 67208 and 67210 distinguish treatment using cryotherapy or diathermy and photocoagulation, respectively.
Does the code include multiple treatment sessions?
Yes. The code covers one or more sessions for the retinal lesion; do not report another unit solely because treatment involves more than one session.
What documentation supports reporting 67218?
Document the retinal lesion and its location, the radiation method, and the treatment performed. The record should support that radiation, rather than laser or cryotherapy, was used.
Can modifier 50 be used for bilateral treatment?
CMS identifies this as a bilateral procedure. When reported bilaterally with modifier 50, it is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid for this procedure?
CMS restricts assistant-at-surgery payment 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 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.
7,44067145,,Proph rta dtchmnt pc,A,,2.47,4.68,,2.98,,0.20,7.35,5.65,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44167208,,Treatment of retinal lesion,A,,7.46,10.06,,6.67,,0.59,18.11,14.72,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44267210,,Treatment of retinal lesion,A,,6.20,8.80,,6.13,,0.49,15.49,12.82,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44367218,,Treatment of retinal lesion,A,,19.85,13.15,NA,13.15,,1.58,34.58,34.58,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44467220,,Treatment of choroid lesion,A,,6.20,9.25,,6.13,,0.48,15.93,12.81,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44567221,,Ocular photodynamic ther,R,,3.36,4.89,,1.42,,0.26,8.51,5.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44667225,,Eye photodynamic ther add-on,A,,0.46,0.37,,0.16,,0.04,0.87,0.66,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00