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

Reports aspiration of vitreous followed by placement of a vitreous substitute, commonly for a retinal condition requiring fluid-gas exchange.

CMS RVU26DEffective Oct 1, 2026One payment locality518 Medicare services in 2024

In Delaware, Medicare pays $736.24 for 67025 in the office and $536.26 when it’s performed in a hospital or facility.

$736.24Office (non-facility)
$536.26Hospital or facility
−0.8%vs the national office rate ($742.50)

Check a contract rate as a % of Medicare · 67025 nationwide

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

We’ll open 67025 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 67025 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Delaware compares for 67025

Across 109 of 109 payment localities, the office rate for 67025 runs from $667.94 in Arkansas to $964.21 in San Benito County, CA. Delaware pays $736.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

67025 in Delaware vs other payment areas
  1. Delaware · this page$736.24
  2. Los Angeles, CA · California$830.12+$93.88
  3. Washington, DC area · District of Columbia$840.56+$104.32
  4. Miami, FL · Florida$792.93+$56.69
  5. Chicago, IL · Illinois$773.46+$37.22
  6. Manhattan, NY · New York$845.68+$109.44
  7. Alaska · Alaska$895.05+$158.81

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

67025 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$676.32$499.21
ArkansasArkansas$667.94$494.07
ArizonaArizona$725.33$529.20
Bakersfield, CACalifornia$783.35$561.51
Chico, CACalifornia$781.31$559.47
El Centro, CACalifornia$781.42$559.58
Fresno, CACalifornia$781.31$559.47
Hanford, CACalifornia$781.31$559.47

67025 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$667.94

$895.05

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
67025 office rate range by state
State / territoryOffice rate rangeLocalities
AK$895.051
AL$676.321
AR$667.941
AZ$725.331
CA$781.31–$964.2129
CO$770.421
CT$787.371
DC$840.561
DE$736.241
FL$732.78–$792.933
GA$697.06–$754.782
GU$796.471
HI$796.471
IA$691.121
ID$694.981
IL$714.35–$773.464
IN$698.451
KS$688.301
KY$689.951
LA$689.01–$718.322
MA$766.78–$839.832
MD$748.94–$840.563
ME$698.07–$730.742
MI$705.36–$740.692
MN$741.191
MO$678.82–$720.583
MS$673.491
MT$742.461
NC$704.371
ND$730.201
NE$694.391
NH$758.671
NJ$797.18–$833.772
NM$708.681
NV$739.501
NY$713.47–$863.645
OH$702.861
OK$688.921
OR$734.52–$792.222
PA$703.84–$770.022
PR$747.221
RI$760.391
SC$704.621
SD$728.751
TN$691.271
TX$699.85–$767.218
UT$712.931
VA$728.63–$840.562
VI$747.221
VT$727.701
WA$765.24–$855.802
WI$708.951
WV$691.481
WY$737.121

See 67025 in every payment locality

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.

How the rate is built · 67025

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.91

7.91 RVUs× 1.000 GPCI

Practice expense13.70

13.70 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

22.2300

Conversion factor

$33.4009

Medicare rate

$742.50

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,419

Code
67025
Physician work
7.91
Practice expense
13.70
Malpractice
0.62

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 67025 in Delaware
ComponentRVULocality factorAdjusted
Physician work7.91× 1.0057.9495
Practice expense13.70× 0.98813.5356
Malpractice0.62× 0.8990.5574
Total RVUs22.0425
Conversion factor× 33.4009

Office rate, Delaware$736.24

Office: (7.91 × 1.005 + 13.7 × 0.988 + 0.62 × 0.899) × $33.4009 = $736.24

Facility: (7.91 × 1.005 + 7.64 × 0.988 + 0.62 × 0.899) × $33.4009 = $536.26

Open 67025 in the RVU calculator

Payment rules and modifiers for 67025

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

CMS payment indicators · 67025

Vitreous exchange, pars plana or limbal approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67025

Vitreous exchange, pars plana or limbal approach

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67025 without 50 · national office

$742.50

Vitreous exchange, pars plana or limbal approach

67025-50 · Bilateral: 150%

$1,113.75

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 67025

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

Codes related to 67025
CodeHow it relatesOffice range, Delaware
Used instead
67015Choroidal drainage, posterior sclerotomyAspiration or release of vitreous without the substitute placement included in 67025.No office rate
67036Vitrectomy, pars plana approachMechanical pars plana vitrectomy when vitreous removal, rather than fluid-gas exchange, is the operative service.No office rate
67005Vitrectomy, partial, anterior approachAnterior-approach vitreous removal, rather than pars plana or limbal substitute exchange.No office rate
67010Anterior vitrectomy, partial removalSubtotal mechanical vitreous removal through an anterior approach, rather than substitute exchange.No office rate

How 67025 has changed in Delaware

67025 · Office / nonfacility

$736.24

Effective 2026-10-01

The base rate is $30.90 higher than on 2025-10-01, moving from $705.34 to $736.24 (4.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $705.34changed to$736.24

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.11 changed to 7.91
    • Practice expense RVU 13.13 changed to 13.70
    • Malpractice RVU 0.63 changed to 0.62
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $732.80changed to$705.34

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 13.34 changed to 13.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $720.84changed to$732.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $747.88changed to$720.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 13.21 changed to 13.34
    • Malpractice RVU 0.64 changed to 0.63
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $760.67changed to$747.88

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.97 changed to 13.21
    • Malpractice RVU 0.62 changed to 0.64
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $765.90changed to$760.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.94 changed to 12.97

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $765.77changed to$765.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.19 changed to 12.94
    • Malpractice RVU 0.60 changed to 0.62
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $764.28changed to$765.77

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.16 changed to 12.19
    • Malpractice RVU 0.58 changed to 0.60
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $759.07changed to$764.28

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.03 changed to 12.16
    • Malpractice RVU 0.59 changed to 0.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $752.83changed to$759.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.84 changed to 12.03
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $753.43changed to$752.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.83 changed to 11.84
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $755.78changed to$753.43

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.82 changed to 11.83

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $752.02changed to$755.78

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $776.93changed to$752.02

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 1.38 changed to 0.59
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $771.08changed to$776.93

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 12.92 changed to 11.82
    • Malpractice RVU 1.44 changed to 1.38
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $771.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$736.24$536.26RVU26D
2026-07-01$736.24$536.26RVU26C
2026-04-01$736.24$536.26RVU26B
2026-01-01$736.24$536.26RVU26A
2025-10-01$705.34$603.94RVU25D
2025-07-01$705.34$603.94RVU25C
2025-04-01$705.34$603.94RVU25B
2025-01-01$705.34$603.94RVU25A
2024-10-01$732.80$622.50RVU24D
2024-07-01$732.80$622.50RVU24C
2024-04-01$732.80$622.50RVU24B
2024-03-09$732.80$622.50RVU24AR
2024-01-01$720.84$612.34RVU24A
2023-10-01$747.88$632.19RVU23D
2023-07-01$747.88$632.19RVU23C
2023-04-01$747.88$632.19RVU23B
2023-01-01$747.88$632.19RVU23A
2022-10-01$760.67$637.94RVU22D
2022-07-01$760.67$637.94RVU22C
2022-04-01$760.67$637.94RVU22B
2022-01-01$760.67$637.94RVU22A
2021-10-01$765.90$642.87RVU21D
2021-07-01$765.90$642.87RVU21C
2021-04-01$765.90$642.87RVU21B
2021-01-01$765.90$642.87RVU21A
2020-10-01$765.77$653.75RVU20D
2020-07-01$765.77$653.75RVU20C
2020-04-01$765.77$653.75RVU20B
2020-01-01$765.77$653.75RVU20A
2019-10-01$764.28$658.51RVU19D
2019-07-01$764.28$658.51RVU19C
2019-04-01$764.28$658.51RVU19B
2019-01-01$764.28$658.51RVU19A
2018-10-01$759.07$660.76RVU18D
2018-07-01$759.07$660.76RVU18C
2018-04-01$759.07$660.76RVU18B
2018-01-01$759.07$660.76RVU18AR1
2017-10-01$752.83$656.81RVU17D
2017-07-01$752.83$656.81RVU17C
2017-04-01$752.83$656.81RVU17B
2017-01-01$752.83$656.81RVU17A
2016-10-01$753.43$657.08RVU16D
2016-07-01$753.43$657.08RVU16C
2016-04-01$753.43$657.08RVU16B
2016-01-01$753.43$657.08RVU16A
2015-10-01$755.78$659.09RVU15D
2015-07-01$755.78$659.09RVU15C
2015-04-01$752.02$655.81RVU15B
2015-01-01$752.02$655.81RVU15A
2014-10-01$776.93$680.25RVU14D
2014-07-01$776.93$680.25RVU14C
2014-04-01$776.93$680.25RVU14B
2014-01-01$776.93$680.25RVU14A
2013-10-01$771.08$668.43RVU13D
2013-07-01$771.08$668.43RVU13C
2013-04-01$771.08$668.43RVU13B
2013-01-01$771.08$668.43RVU13AR

Price 67025 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

67025 billing questions

When should this be reported instead of 67015?

Report 67025 when the surgeon aspirates vitreous and replaces it with a vitreous substitute. Code 67015 describes aspiration or release without that replacement.

Is vitreous aspiration included in this service?

Yes. Aspiration is part of the vitreous exchange service; do not separately report aspiration for the same work.

How does this differ from 67036?

67025 centers on vitreous aspiration and substitute placement. Use 67036 when the documented service is mechanical pars plana vitrectomy.

What documentation supports reporting this code?

The operative report should establish the indication, treated eye, pars plana or limbal approach, vitreous aspiration, and placement of a substitute.

How is bilateral surgery handled?

CMS pays bilateral reporting with modifier 50 at 150%. The code also has a 90-day global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted by statute. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

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

Show the CMS file lines behind this rate
RVUs for 67025PPRRVU2026_Oct_nonQPP.csv, line 7,419 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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