Price Checker / CPT 67225

CPT 67225Eye photodynamic ther add-on

2026 Medicare Physician Fee Schedule rates and hospital pricing data

Medicare Rate (Facility)

$22

What Medicare pays in a hospital/ASC setting

Medicare Rate (Office)

$29

What Medicare pays in a physician's office

Avg Hospital Charge

$5,219

Based on 194 hospital(s) in our database

What do these numbers mean?

The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.

Hospital Charges for CPT 67225

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
LOS ROBLES HOSPITAL AND MEDICAL CENTER

, CA

49804%
THOUSAND OAKS SURGICAL HOSPITAL

, CA

49804%
RESEARCH MEDICAL CENTER

Kansas City, MO

49109%
Sequoia Hospital

, CA

35702%
Jefferson Methodist Hospital

, PA

35523%
Thomas Jefferson University Hospital

, PA

35523%
CENTENNIAL MEDICAL CENTER AT ASHLAND CITY

, TN

33916%
HENDERSONVILLE MEDICAL CENTER

, TN

33916%
HORIZON MEDICAL CENTER

, TN

33916%
NORTHCREST MEDICAL CENTER

, TN

33916%
PARKRIDGE CAMP JORDAN ER

, TN

33916%
PARKRIDGE EAST HOSPITAL

, TN

33916%
PARKRIDGE MEDICAL CENTER

, TN

33916%
PARKRIDGE NORTH ER

, TN

33916%
PARKRIDGE SODDY-DAISY ER

, TN

33916%

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About CPT 67225

CPT code 67225 refers to “Eye photodynamic ther add-on”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $22 in a facility (hospital or ambulatory surgery center) and $29in a non-facility (physician's office) setting.

These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.

What to do if you were overcharged

  1. Upload your bill— we'll identify this code and compare it against the rates shown above.
  2. Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
  3. Negotiate or let us handle it — 25% of savings, no savings = no fee.

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