CPT code 67025: Vitreous exchange, pars plana or limbal approach2026 Medicare rate & RVUs

Medicare pays $742.50 for 67025 nationally in the office and $540.09 in a hospital or facility. Local office rates run $667.94–$964.21.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 67025 covers

An ophthalmologist, often a retina surgeon, performs this procedure through a pars plana or limbal approach. The surgeon aspirates vitreous and introduces a substitute, such as gas, to exchange the eye’s internal fluid. It may be used in retinal care when an exchange is needed, including in selected retinal detachment cases. The service is generally performed in an operating room or ambulatory surgery setting.

Report the procedure when the operative work includes both vitreous aspiration and replacement with a substitute; aspiration or release alone and mechanical vitrectomy are distinct services. The operative note should identify the indication, eye, approach, aspiration, and substitute placed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 for bilateral surgery is paid at 150%. Assistant-at-surgery payment is restricted by statute; co-surgeons require supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 67025 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

67025 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 67025 rate is calculated

Each of 67025’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 67025

67025 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

67025 compared with similar codes

How to choose

67015Choroidal drainagePosterior sclerotomy

67015 describes aspiration or release of vitreous. Choose 67025 when the procedure also introduces a vitreous substitute.

67036VitrectomyPars plana approach

67036 is mechanical pars plana vitrectomy. Choose 67025 for aspiration with substitute placement rather than mechanical vitreous removal as the principal service.

67028Intravitreal injectionMedication delivered into vitreous cavity

67028 reports an intravitreal pharmacologic injection. It does not describe exchanging vitreous with a substitute.

Codes related to 67025

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates