CPT 67218 Surgery - Eye
Treatment of retinal lesion Cost
Body System: Eye
Medicare Facility Rate
$1,155
CMS PFS CY2026
Medicare Non-Facility Rate
$1,155
Office/clinic setting
Hospital Outpatient
$4
OPPS rate
Surgery Center (ASC)
$1
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
19.85
Work RVU
13.15
Facility PE RVU
1.58
Malpractice RVU
34.58
Total RVU
Frequently Asked Questions
How much does Treatment of retinal lesion cost?
The Medicare facility rate is $1,155. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $4. Ambulatory surgery center rate: $1.
How much does Treatment of retinal lesion cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $1,155.