How much does Medicare pay for CPT 67039?

Medicare allowed an average of $1404.42 per service and paid $1117.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $6166.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67039?

Destruction of eye fluid (vitreous) between lens and retina using a laser. It was billed 3,389 times to 3,164 Medicare beneficiaries by 156 providers in 2024.

Which specialty bills 67039 most?

Ambulatory Surgical Center, with 1,711 services from 75 clinicians. Next are Ophthalmology.

CPT 67039

Destruction of eye fluid (vitreous) between lens and retina using a laser

$1404.42Medicare-allowed amount per service, averaged across 3,389 services

Providers submitted

$6166.83

Asking price, not received

Medicare allowed

$1404.42

The fee schedule figure

Medicare paid

$1117.59

Balance is patient coinsurance

Providers submitted an average of $6166.83 for this code and Medicare allowed $1404.42 — 4.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $1117.59 (80%); the rest is the patient’s coinsurance and deductible.

Services: 3,389
Beneficiaries: 3,164
Providers billing it: 156
Total allowed: $4,759,579

What Medicare pays for CPT 67039

Across 3,389 services billed by 156 providers to 3,164 beneficiaries, Medicare allowed an average of $1404.42 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 67039

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	1,711	1,618	$1977.41	75
Ophthalmology	1,678	1,546	$820.16	81

67039 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	545	$1497.63	$1012.09	18
Florida	504	$1411.91	$1177.98	21
Arizona	369	$1466.79	$1172.12	14
Texas	368	$1632.31	$1324.05	16
Pennsylvania	250	$1057.79	$807.12	13
Indiana	128	$1621.77	$1344.11	4
Colorado	101	$1667.53	$1327.93	5
Minnesota	84	$1377.39	$1068.08	4
Illinois	83	$653.75	$545.89	5
Alabama	77	$1130.66	$994.50	2
North Carolina	69	$888.73	$742.83	4
Mississippi	68	$1259.56	$1193.42	4
Kentucky	68	$1484.66	$1240.97	5
Washington	65	$2167.74	$1589.07	3
South Dakota	63	$1299.35	$1086.22	4
Michigan	61	$1353.32	$1086.73	3
Massachusetts	61	$1545.60	$1176.07	3
Arkansas	52	$839.91	$731.63	2
Oklahoma	44	$1091.87	$907.09	3
Kansas	41	$1428.66	$1176.00	2
Tennessee	32	$1815.93	$1615.67	2
Iowa	28	$1300.58	$1113.35	2
Maine	28	$1980.17	$1598.94	2
Ohio	25	$1905.08	$1595.62	2
New Jersey	25	$1030.83	$768.99	2
New York	25	$1144.16	$771.58	2
District of Columbia	22	$167.70	$118.40	1
Montana	16	$992.05	$742.21	1
Nebraska	16	$1967.99	$1591.39	1
New Hampshire	13	$225.21	$163.98	1
Wisconsin	12	$1913.13	$1536.34	1
Oregon	12	$992.82	$739.18	1
Virginia	12	$1048.08	$738.17	1
New Mexico	11	$1912.58	$1603.20	1
Louisiana	11	$1827.45	$1592.16	1

Related codes

67028Injection of drug into eye$122.07
67042Removal of membrane of retina$1420.62
67036Removal of eye fluid (vitreous) between lens and retina$1259.65
67041Removal of membrane of retina$1398.21
67031Release of scar tissue between lens and retina$364.90
67040Destruction of eye fluid (vitreous) between lens and retina and all of$1465.17

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.