How much does Medicare pay for CPT 67145?

Medicare allowed an average of $235.48 per service and paid $178.38 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1339.16, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67145?

Photocoagulation treatment to prevent detachment of retina. It was billed 19,575 times to 17,461 Medicare beneficiaries by 868 providers in 2024.

Does 67145 pay differently in an office than a hospital?

Yes. The allowed amount averaged $243.70 in an office setting and $171.25 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 67145 most?

Ophthalmology, with 18,486 services from 835 clinicians. Next are Ambulatory Surgical Center.

CPT 67145

Photocoagulation treatment to prevent detachment of retina

$235.48Medicare-allowed amount per service, averaged across 19,575 services

Providers submitted

$1339.16

Asking price, not received

Medicare allowed

$235.48

The fee schedule figure

Medicare paid

$178.38

Balance is patient coinsurance

Providers submitted an average of $1339.16 for this code and Medicare allowed $235.48 — 5.7× 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 $178.38 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $243.70
Hospital / facility: $171.25

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 17,355 services were billed in an office setting and 2,220 in a facility.

Services: 19,575
Beneficiaries: 17,461
Providers billing it: 868
Total allowed: $4,609,521

What Medicare pays for CPT 67145

Across 19,575 services billed by 868 providers to 17,461 beneficiaries, Medicare allowed an average of $235.48 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 67145

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	18,486	16,485	$241.35	835
Ambulatory Surgical Center	1,089	976	$135.88	33

67145 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	1,774	$270.67	$181.65	76
Florida	1,618	$235.77	$178.54	58
Texas	1,443	$226.24	$167.87	63
Pennsylvania	903	$243.84	$180.80	46
Virginia	903	$238.17	$172.11	35
New York	861	$266.38	$178.26	40
Illinois	803	$234.71	$172.17	33
Colorado	654	$225.31	$160.61	26
Maryland	585	$246.85	$176.48	26
Ohio	574	$219.92	$170.06	25
Massachusetts	556	$238.63	$165.38	27
North Carolina	549	$223.25	$178.97	27
Indiana	491	$219.09	$169.03	20
Arizona	490	$240.88	$174.70	22
Louisiana	481	$222.44	$178.89	19
Oklahoma	453	$228.48	$182.01	13
South Carolina	427	$229.77	$182.51	17
Washington	387	$210.83	$147.97	16
Wisconsin	357	$227.43	$171.52	16
Tennessee	355	$226.29	$182.47	22
Georgia	315	$232.50	$176.58	16
Kansas	309	$233.22	$173.33	12
Nebraska	302	$194.36	$153.60	13
Mississippi	291	$205.85	$163.72	10
New Jersey	285	$267.05	$183.15	15
South Dakota	268	$221.40	$167.62	8
Kentucky	260	$224.63	$177.81	14
Michigan	259	$240.84	$181.91	15
Oregon	224	$222.81	$160.33	13
Nevada	219	$241.44	$179.54	9
Iowa	202	$221.99	$168.28	10
Missouri	199	$226.39	$179.69	13
Alabama	186	$207.25	$173.96	10
Connecticut	180	$266.84	$179.71	12
Montana	179	$245.01	$176.12	6
Minnesota	166	$242.67	$180.00	11
Maine	162	$177.63	$137.13	8
New Hampshire	142	$237.18	$179.29	6
New Mexico	128	$228.51	$184.84	7
Arkansas	108	$223.09	$185.60	6
North Dakota	105	$240.15	$174.36	3
Idaho	103	$213.04	$154.51	5
West Virginia	95	$218.23	$166.00	5
Utah	63	$234.45	$178.31	5
Alaska	46	$168.53	$108.83	2
Vermont	33	$229.17	$178.30	2
Hawaii	29	$267.54	$180.70	2
Delaware	28	$245.37	$178.27	2
Rhode Island	25	$235.84	$176.22	1

Related codes

67108Repair of detached retina$1401.34
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.