$293.32–$315.52
Both address extensive or progressive retinopathy, but 67227 uses cryotherapy; this code is for photocoagulation.
On this page
CMS RVU26D · Effective 2026-10-01
67228 Retinal laser Medicare reimbursement rates in Oregon
Reports retinal laser treatment for extensive or progressive retinopathy, commonly proliferative diabetic retinopathy, including treatment delivered over one or more sessions. Compare 67228 office and facility rates across CMS payment localities in Oregon.
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 67228 in Oregon?
Oregon 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
$336.81–$361.01
2 of 2 localities have a supported rate.
Facility setting
$249.98–$264.15
2 of 2 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.
Ophthalmology
About 67228: Retinal photocoagulation for progressive retinopathy
Reports retinal laser treatment for extensive or progressive retinopathy, commonly proliferative diabetic retinopathy, including treatment delivered over one or more sessions.
An ophthalmologist uses laser photocoagulation to treat extensive or progressive retinal disease. A common setting is proliferative diabetic retinopathy treated with scatter laser, often called panretinal photocoagulation. The treatment may be delivered over more than one session; the code encompasses one or more sessions rather than describing a single laser spot or isolated retinal lesion. Documentation should identify the treated eye, the retinopathy and its extent or progression, and the laser treatment performed.
Select this service for extensive or progressive retinopathy treated with photocoagulation, not a localized retinal lesion or a different treatment method. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 67228
- 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 RVU4.28 · 42%
- Practice expense (office) RVU5.58 · 55%
- Malpractice RVU0.35 · 3%
36.2K
Medicare services in 2024 · #908 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.
67228 compared with similar codes
Office rates for Oregon, from the same CMS release.
$511.34–$549.13
Use 67210 for photocoagulation of a localized retinal lesion. This code is for extensive or progressive retinopathy.
$597.69–$641.13
Code 67208 treats a localized retinal lesion with cryotherapy; this code treats extensive or progressive retinopathy with photocoagulation.
Compare 67228 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
Portland →
Office / nonfacility
$361.01
Facility
$264.15
Rest Of Oregon →
Office / nonfacility
$336.81
Facility
$249.98
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67228 billing questions
When is this code appropriate instead of 67210?
Use this code for laser treatment of extensive or progressive retinopathy, such as proliferative diabetic retinopathy. Code 67210 describes photocoagulation for a localized retinal lesion.
Can the code be reported for each laser session?
The service covers one or more sessions. A series of sessions for the same treatment is not automatically reported as a separate service for every visit.
How should bilateral treatment be reported?
Report modifier 50 for bilateral treatment; Medicare pays the bilateral procedure at 150%.
Are related postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures subject to the standard multiple procedure reduction are paid at 50%.
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.
7,44567221,,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
7,44767227,,Dstrj extensive retinopathy,A,,3.41,5.21,,2.77,,0.26,8.88,6.44,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44867228,,Treatment x10sv retinopathy,A,,4.28,5.58,,2.97,,0.35,10.21,7.60,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44967229,,Tr retinal les preterm inf,A,,15.89,11.88,NA,11.88,,1.27,29.04,29.04,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45067250,,Reinforce eye wall,A,,9.37,13.70,NA,13.70,,0.75,23.82,23.82,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45167255,,Reinforce/graft eye wall,A,,8.17,9.04,NA,9.04,,0.65,17.86,17.86,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00