Table 1.
Medicare Allowable Costs for Retinal Detachment Repair and Associated Treatments
| Facility, Hospital Operating Room Surgery | Non-Facility, ASC Surgery | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Procedure | CPT Code | Professional | Non-technical | Anesthesia | Total | Professional | Nontechnical | Anesthesia | Total |
| PR | 67110 | $901 | $1,442 | – | $2,343 | $1,005 | $0 | – | $1,005 |
| SB | 67107 | $1,493 | $2,914 | $255 | $4,662 | $1,493 | $1,635 | $255 | $3,383 |
| PPV | 67108 | $1,892 | $2,914 | $255 | $5,061 | $1,892 | $1,635 | $255 | $3,782 |
| PPV +/− SB | 67112 | $1,563 | $2,914 | $255 | $4,732 | $1,563 | $1,635 | $255 | $3,453 |
| Laser prophylaxis of RD | 67145 | $583 | $411 | – | $994 | $615 | $0 | – | $615 |
| Cataract surgery | 66984 | $769 | $1,730 | $153 | $2,652 | $769 | $971 | $153 | $1,893 |
| Level 4 new patient visit | 99204 | $145 | $128 | – | $273 | $183 | $0 | – | $183 |
| Level 3 follow up visit | 99213 | $55 | $74 | – | $128 | $79 | $0 | – | $79 |
All amounts are in United States dollars. ASC = ambulatory surgery center, CPT = current procedural terminology, PR = pneumatic retinopexy, SB = scleral buckle, PPV = pars plana vitrectomy, RD = retinal detachment.