How much does Medicare pay for CPT 67210?

Medicare allowed an average of $529.88 per service and paid $417.09 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1386.91, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67210?

Destruction of growth of retina using a laser. It was billed 24,611 times to 13,186 Medicare beneficiaries by 355 providers in 2024.

Does 67210 pay differently in an office than a hospital?

Yes. The allowed amount averaged $545.58 in an office setting and $414.45 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 67210 most?

Ophthalmology, with 22,858 services from 336 clinicians. Next are Ambulatory Surgical Center, General Surgery.

CPT 67210

Destruction of growth of retina using a laser

$529.88Medicare-allowed amount per service, averaged across 24,611 services

Providers submitted

$1386.91

Asking price, not received

Medicare allowed

$529.88

The fee schedule figure

Medicare paid

$417.09

Balance is patient coinsurance

Providers submitted an average of $1386.91 for this code and Medicare allowed $529.88 — 2.6× 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 $417.09 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $545.58
Hospital / facility: $414.45

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. 21,665 services were billed in an office setting and 2,946 in a facility.

Services: 24,611
Beneficiaries: 13,186
Providers billing it: 355
Total allowed: $13,040,877

What Medicare pays for CPT 67210

Across 24,611 services billed by 355 providers to 13,186 beneficiaries, Medicare allowed an average of $529.88 per service. That is 1.9 services per beneficiary, so this is a code patients typically receive more than once. 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 67210

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	22,858	12,266	$545.06	336
Ambulatory Surgical Center	1,446	773	$298.32	18
General Surgery	307	147	$490.63	1

67210 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	7,451	$580.63	$404.34	47
New York	4,437	$528.04	$361.79	39
Florida	1,868	$526.08	$411.25	23
Texas	1,281	$502.05	$403.56	21
Illinois	1,025	$504.91	$390.31	20
Pennsylvania	896	$472.03	$370.67	20
Maryland	681	$520.16	$396.45	12
New Jersey	602	$548.74	$393.08	13
Alabama	566	$583.82	$478.48	6
Louisiana	509	$487.41	$393.25	15
Nevada	421	$484.23	$392.79	3
Virginia	372	$464.21	$377.87	11
Indiana	345	$465.98	$376.90	11
Iowa	335	$519.63	$411.22	2
West Virginia	320	$477.33	$407.95	6
Arkansas	288	$440.77	$396.83	2
Michigan	283	$526.87	$412.89	13
Utah	262	$508.09	$399.27	1
Missouri	258	$538.60	$451.28	6
Ohio	246	$416.51	$341.85	8
Oklahoma	226	$467.69	$396.12	4
Arizona	197	$515.73	$389.38	6
Georgia	175	$476.49	$394.21	7
Nebraska	163	$333.26	$271.01	4
North Carolina	154	$470.23	$394.07	8
South Carolina	138	$481.68	$391.98	6
Colorado	136	$444.12	$344.60	4
Connecticut	135	$510.22	$395.33	3
Mississippi	128	$454.02	$386.14	5
Washington	111	$519.30	$392.52	5
Kentucky	97	$490.62	$399.61	4
Hawaii	89	$524.15	$403.72	1
Tennessee	70	$478.38	$398.05	3
Oregon	58	$518.63	$411.38	3
New Hampshire	48	$489.13	$375.74	2
AE	48	$477.20	$399.57	1
Puerto Rico	45	$496.95	$391.36	2
Massachusetts	45	$532.81	$386.63	3
Wisconsin	29	$444.75	$391.69	1
Idaho	29	$466.80	$385.78	1
Kansas	27	$480.28	$379.92	2
Minnesota	17	$514.99	$374.59	1

Related codes

67228Destruction of leaking blood vessels of retina$328.65

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.