CPT 67208
Global 090 ActiveTreatment of retinal lesion
CPT 67208 Billing & Documentation Guide
CPT code 67208 (Treatment of retinal lesion) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 7.46, a non-facility practice expense RVU of 10.06, and a malpractice RVU of 0.59, a total non-facility RVU of 18.11 and facility RVU of 14.72. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $621.81, though rates vary from $547.95 to $771.67 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 67208, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 67208 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 67208 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 67208
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 7.46 | 7.46 |
| Practice Expense RVU | 10.06 | 6.67 |
| Malpractice RVU | 0.59 | 0.59 |
| Total RVU | 18.11 | 14.72 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 67208
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $666.38 | $532.4 | $632.24 - $771.67 | 29 |
| Florida | $624.67 | $511.06 | $600.02 - $648.8 | 3 |
| Georgia | $593.68 | $485.66 | $572.38 - $614.98 | 2 |
| Illinois | $612.37 | $502.97 | $586.75 - $633.83 | 4 |
| Michigan | $592.43 | $486.1 | $578.2 - $606.65 | 2 |
| North Carolina | $575.26 | $469.62 | $575.26 - $575.26 | 1 |
| New York | $662.63 | $536.31 | $582.24 - $701.23 | 5 |
| Ohio | $575.81 | $472.44 | $575.81 - $575.81 | 1 |
| Pennsylvania | $601.61 | $490.7 | $576.25 - $626.96 | 2 |
| Texas | $599.65 | $488.17 | $573.25 - $622.63 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 67208
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 67208 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0124T | Column 1 (primary), can be billed with modifier | Yes | Anesthesia service included in surgical procedure |
| 0186T | Column 1 (primary), can be billed with modifier | Yes | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0465T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 67208
What does CPT code 67208 mean? +
CPT code 67208 represents: Treatment of retinal lesion. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 67208? +
The 2026 Medicare national average non-facility payment for CPT 67208 is $621.81. Rates range from $547.95 to $771.67 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 67208? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 67208? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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