Billing code 67210: Retinal laserMedicare rate & RVUs in Utah
Reports ophthalmic photocoagulation to destroy a localized retinal lesion, such as macular edema or a retinal tumor, in one or more sessions.
Medicare pays $498.07 for 67210 in the office in Utah (Utah). 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 67210 covers
billing code 67210 covers laser photocoagulation directed at a localized retinal lesion, including treatment for macular edema or a retinal tumor. An ophthalmologist, often a retina specialist, applies laser energy to the affected retinal area in an office or surgical setting. The code is specific to retinal tissue and photocoagulation; it is not the code for cryotherapy or treatment of a choroidal lesion.
Report the service based on the documented lesion, treated eye, and photocoagulation performed. The code encompasses one or more treatment sessions; document the clinical indication and treated retinal area. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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.
67210 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $498.07 | $414.25 |
How the 67210 rate is calculated
Each of 67210’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 · 67210
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.20Practice expense 8.80Malpractice 0.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67210
67210 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67210
Retinal laser
| 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 · 67210
Retinal laser
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
67210 without 50 · national office
$517.38
Retinal laser
67210-50 · Bilateral: 150%
$776.07
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).
67210 compared with similar codes
Compare codes
67210 vs 67208 vs 67218 vs 67220 vs 67228: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67208Retinal treatment
- Choose 67210 for photocoagulation of a localized retinal lesion. Choose 67208 when the lesion is treated by cryotherapy or diathermy.
- 67218Retinal treatment
- Both address localized retinal lesions, but 67218 is for treatment by radiation therapy rather than photocoagulation.
- 67220Choroidal lesion treatment
- 67210 treats a localized retinal lesion with photocoagulation; 67220 is for a localized lesion in the choroid.
- 67228Retinal laser
- 67210 is for a localized retinal lesion. 67228 is used for photocoagulation of extensive retinopathy.
67210 billing questions
How does 67210 differ from 67208?
67210 is for photocoagulation of a localized retinal lesion. 67208 is used when the retinal lesion is treated with cryotherapy or diathermy.
Does 67210 include multiple laser spots or sessions?
The code covers one or more treatment sessions for the localized lesion. Document the treated area and service rather than reporting each laser spot as a separate unit.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported under the CMS payment rule?
When the service is performed bilaterally and reported with modifier 50, CMS pays 150%.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery 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 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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