{
    "code": "67028",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/67028/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/67028/2019/D",
    "description": "An injection of drug straight into the vitreous, the clear gel filling the back of the eye. After numbing drops and an antiseptic prep, a very fine needle passes through the white of the eye a few millimeters behind the iris and delivers the medicine where it can act directly on the retina. It is an office procedure that takes seconds, and it is usually repeated on a schedule of weeks to months for as long as the underlying disease stays active. The code covers the act of injecting; the drug itself is a separate matter.",
    "answer": {
        "question": "How much did Medicare pay for CPT 67028 in Q4 2019?",
        "text": "Medicare paid $104.15 for CPT 67028 in the office (non-facility) setting and $101.99 in a facility under the Q4 2019 Physician Fee Schedule, effective October 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it decreased 0.2%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "D",
        "label": "Q4 2019",
        "effective": "October 1 – December 31, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 104.15,
        "facility": 101.99,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.44,
        "practice_expense_non_facility": 1.34,
        "practice_expense_facility": 1.28,
        "malpractice": 0.11
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q4 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/D",
        "file": "PPRRVU19_OCT.csv",
        "row": 11557,
        "sha256": "4efa7bdbffa98a56affa6d5b05e25d7ac5c39f26c7b281d0c773e7e530767cae"
    },
    "modified_at": "2026-08-04T03:09:13+00:00"
}