CPT code 67220: Choroidal lesion treatment2026 Medicare rate & RVUs in Texas
Laser photocoagulation to destroy a localized choroidal lesion is reported when the treated target is in the choroid, not the retina.
Medicare pays $503.13–$548.58 for 67220 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 67220 covers
An ophthalmologist, often a retina or ocular oncology specialist, uses laser photocoagulation to destroy a localized lesion in the choroid. The code can cover one or more treatment sessions for that lesion. The key distinction is the treated tissue: a choroidal target supports this code, while a retinal target points to a retinal-lesion code. Treatment is commonly performed in an ophthalmology office or an outpatient facility.
Report the service based on the lesion’s choroidal location and the laser treatment documented. The record should identify the treated eye and lesion and describe the photocoagulation performed. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. 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 others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
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.
Where 67220 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$503.13 to $548.58
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $548.58 | $438.33 |
| Beaumont | $503.13 | $408.30 |
| Brazoria | $527.43 | $424.15 |
| Dallas | $530.43 | $426.63 |
| Fort Worth | $527.55 | $424.79 |
| Galveston | $528.81 | $425.33 |
| Houston | $537.60 | $434.12 |
| Rest Of Texas | $514.76 | $415.87 |
How the 67220 rate is calculated
Each of 67220’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 67220
RVUs × geographic indexes × conversion factor
Work6.20
6.20 RVUs× 1.000 GPCI
Practice expense9.25
9.25 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
15.9300
Conversion factor
$33.4009
Medicare rate
$532.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67220
67220 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67220
Choroidal lesion treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67220
Choroidal lesion treatment
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67220 without 50 · national office
$532.08
Choroidal lesion treatment
67220-50 · Bilateral: 150%
$798.12
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
67220 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 67208Retinal treatment
- 67208 treats a localized retinal lesion with cryotherapy. This code treats a localized choroidal lesion with photocoagulation.
- 67210Retinal laser
- 67210 is photocoagulation for a retinal lesion. Choose this code when the documented treatment target is choroidal.
- 67218Retinal treatment
- 67218 uses a radioactive plaque for a localized choroidal lesion; this code describes photocoagulation of the lesion.
- 67221Ocular photodynamic ther
- 67221 describes photodynamic therapy for a choroidal lesion. This code is selected for photocoagulation instead.
67220 billing questions
How does this differ from 67210?
This code is for laser treatment of a choroidal lesion. Use 67210 when the treated lesion is in the retina.
How does this differ from 67218?
Both concern a localized choroidal lesion, but 67218 describes treatment with a radioactive plaque. This code is for photocoagulation.
Does one or more treatment sessions change the code?
The code covers one or more sessions. Document the lesion and the photocoagulation performed; do not select a retinal-lesion code just because treatment required multiple sessions.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for treatment of both eyes?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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