How much does Medicare pay for CPT 67108?

Medicare allowed an average of $1401.34 per service and paid $1115.07 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $6257.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67108?

Repair of detached retina with drainage and removal of eye fluid between lens and retina. It was billed 15,794 times to 15,034 Medicare beneficiaries by 725 providers in 2024.

Does 67108 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1023.30 in an office setting and $1405.67 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 67108 most?

Ophthalmology, with 8,454 services from 486 clinicians. Next are Ambulatory Surgical Center, Physician Assistant.

CPT 67108

Repair of detached retina with drainage and removal of eye fluid between lens and retina

$1401.34Medicare-allowed amount per service, averaged across 15,794 services

Providers submitted

$6257.83

Asking price, not received

Medicare allowed

$1401.34

The fee schedule figure

Medicare paid

$1115.07

Balance is patient coinsurance

Providers submitted an average of $6257.83 for this code and Medicare allowed $1401.34 — 4.5× 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 $1115.07 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1023.30
Hospital / facility: $1405.67

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 179 services were billed in an office setting and 15,615 in a facility.

Services: 15,794
Beneficiaries: 15,034
Providers billing it: 725
Total allowed: $22,132,764

What Medicare pays for CPT 67108

Across 15,794 services billed by 725 providers to 15,034 beneficiaries, Medicare allowed an average of $1401.34 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 67108

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	8,454	8,110	$963.32	486
Ambulatory Surgical Center	7,071	6,661	$1972.05	227
Physician Assistant	269	263	$165.34	12

67108 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	1,397	$1480.15	$983.80	58
Florida	1,353	$1480.66	$1228.10	56
Texas	1,282	$1567.58	$1283.96	55
Ohio	878	$1244.01	$1039.81	36
Tennessee	769	$1376.48	$1197.73	28
Pennsylvania	590	$1057.99	$812.40	29
New York	574	$1238.85	$918.85	32
Arizona	552	$1574.74	$1271.63	25
Colorado	505	$1571.50	$1236.23	22
Indiana	467	$1508.62	$1238.58	18
Missouri	446	$1281.93	$1048.08	20
Virginia	433	$1542.05	$1268.31	22
Washington	415	$1555.23	$1150.56	17
Kansas	405	$1451.12	$1204.61	17
South Carolina	376	$1477.13	$1252.42	20
Iowa	356	$1157.99	$988.64	13
Illinois	347	$997.13	$799.80	21
Massachusetts	337	$1164.87	$883.40	19
Kentucky	304	$1443.60	$1219.87	12
New Jersey	289	$1224.46	$906.20	16
Minnesota	262	$1640.23	$1275.71	9
Maryland	261	$1547.77	$1211.18	13
South Dakota	258	$1461.53	$1231.41	8
North Carolina	258	$1293.72	$1089.26	14
Nebraska	227	$1470.84	$1208.28	9
Oregon	226	$1215.21	$917.62	13
Georgia	215	$1646.72	$1341.42	9
Alabama	189	$1242.81	$1124.55	11
Wisconsin	184	$1349.39	$1119.09	10
Oklahoma	168	$1293.38	$1075.69	10
Utah	161	$1403.94	$1140.57	10
Mississippi	156	$1366.33	$1195.13	9
Montana	145	$1455.72	$1180.14	7
Louisiana	130	$1386.85	$1183.74	7
Nevada	101	$1235.42	$960.22	6
Michigan	86	$1257.27	$1034.49	6
Idaho	85	$1396.97	$1159.23	5
Arkansas	78	$1041.41	$903.25	5
District of Columbia	61	$287.02	$209.64	3
New Mexico	60	$1616.49	$1356.51	2
Connecticut	53	$2170.00	$1599.61	4
Hawaii	50	$1671.91	$1176.71	3
Vermont	50	$1512.21	$1222.52	3
New Hampshire	49	$504.92	$387.70	2
Alaska	48	$1957.91	$1393.16	2
Maine	39	$1977.50	$1600.62	2
Wyoming	38	$1555.69	$1234.17	2
North Dakota	35	$1202.15	$915.35	2
Rhode Island	21	$2013.31	$1603.15	1
Delaware	14	$1122.47	$895.55	1
West Virginia	11	$1113.15	$893.07	1

Related codes

67145Photocoagulation treatment to prevent detachment of retina$235.48
67113Complex repair of detached retina and drainage of eye fluid between le$1795.43

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.