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CMS RVU26D · Effective 2026-10-01

67505 Orbital injection Medicare reimbursement rates in New Jersey

Report this service when an ophthalmologist places therapeutic medication into the retrobulbar space to treat an ocular or orbital condition. Compare 67505 office and facility rates across CMS payment localities in New Jersey.

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 67505 in New Jersey?

New Jersey 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

$90.66–$94.44

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $3.78 per service.

Facility setting

$61.48–$63.44

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $1.96 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 67505 in your payment locality →

Ophthalmology procedure

About 67505: Retrobulbar therapeutic medication injection

Report this service when an ophthalmologist places therapeutic medication into the retrobulbar space to treat an ocular or orbital condition.

An ophthalmologist or other qualified eye-care physician uses this service to deliver medication into the retrobulbar space behind the globe. A typical clinical use is a therapeutic corticosteroid injection for orbital inflammation. The injection is distinct from placing medication beneath the conjunctiva or into the suprachoroidal space, and from an injection performed solely to provide anesthesia. It may be performed in an office or facility setting when the retrobulbar route is clinically selected.

Select this code based on the therapeutic purpose and retrobulbar injection site, not simply because medication was given near the eye. Documentation should identify the medication, treatment indication, route and site, and the eye treated. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. 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. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 67505

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.15 · 45%
  • Practice expense (office) RVU1.31 · 52%
  • Malpractice RVU0.08 · 3%

61

Medicare services in 2024 · #5234 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.

67505 compared with similar codes

Office rates for New Jersey, from the same CMS release.

67500

Eye injection

Retrobulbar medication

$84.09–$87.47

Both use the retrobulbar route, but 67505 is for therapeutic medication and 67500 is for an anesthetic agent.

67515

Eye injection

Tenon's capsule

$55.28–$57.51

Both describe therapeutic medication injections near the eye. Choose 67505 for the retrobulbar space and 67515 for the subconjunctival site.

67516

Eye injection

Suprachoroidal route

$129.83–$135.45

67516 identifies medication delivery into the suprachoroidal space; 67505 identifies a retrobulbar injection.

Compare 67505 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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67505 billing questions

How is 67505 different from 67500?

67505 is for therapeutic medication injected retrobulbarly. 67500 describes a retrobulbar injection of anesthetic agent.

When should 67515 be reported instead?

Use 67515 when the therapeutic medication is injected beneath the conjunctiva. The injection site, not just the medication, distinguishes it from the retrobulbar route in 67505.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How is bilateral treatment paid?

CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.

Can 67505 be reported with another procedure in the same session?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

What documentation supports 67505?

Document the therapeutic purpose, medication, retrobulbar route and site, and the eye treated. The record should distinguish treatment from an anesthetic injection or medication delivered at another site.

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 67505PPRRVU2026_Oct_nonQPP.csv, line 7,480 (RVU26D)