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

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 Queens, NY, Medicare pays $851.85 for 67025 in the office and $612.60 when it’s performed in a hospital or facility.

$851.85Office (non-facility)
$612.60Hospital or facility
+14.7%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $851.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

67025 in Queens, NY vs other payment areas
  1. Queens, NY · this page$851.85
  2. Manhattan, NY · New York$845.68−$6.17
  3. NYC suburbs and Long Island, NY · New York$863.64+$11.79
  4. Poughkeepsie and northern NYC suburbs, NY · New York$802.21−$49.64
  5. Rest of New York · New York$713.47−$138.38
  6. Los Angeles, CA · California$830.12−$21.73
  7. Washington, DC area · District of Columbia$840.56−$11.29

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

Every other payment area

67025 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$792.93$582.22
Chicago, ILIllinois$773.46$570.04
AlaskaAlaska$895.05$679.48
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 67025 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work7.91× 1.0648.4162
Practice expense13.70× 1.18216.1934
Malpractice0.62× 1.4420.8940
Total RVUs25.5037
Conversion factor× 33.4009

Office rate, Queens, NY$851.85

Office: (7.91 × 1.064 + 13.7 × 1.182 + 0.62 × 1.442) × $33.4009 = $851.85

Facility: (7.91 × 1.064 + 7.64 × 1.182 + 0.62 × 1.442) × $33.4009 = $612.60

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, Queens, NY
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 Queens, NY

67025 · Office / nonfacility

$851.85

Effective 2026-10-01

The base rate is $35.15 higher than on 2025-10-01, moving from $816.70 to $851.85 (4.3%).

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

    $816.70changed to$851.85

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $848.81changed to$816.70

    • 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

    $834.96changed to$848.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $878.84changed to$834.96

    • 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 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $904.65changed to$878.84

    • 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 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $910.86changed to$904.65

    • 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

    $894.34changed to$910.86

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $877.69changed to$894.34

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $871.88changed to$877.69

    • 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

    $861.64changed to$871.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.84 changed to 12.03
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $859.40changed to$861.64

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.83 changed to 11.84
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $862.07changed to$859.40

    • 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

    $857.78changed to$862.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $904.69changed to$857.78

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 1.38 changed to 0.59
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $891.38changed to$904.69

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $891.38

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$851.85$612.60RVU26D
2026-07-01$851.85$612.60RVU26C
2026-04-01$851.85$612.60RVU26B
2026-01-01$851.85$612.60RVU26A
2025-10-01$816.70$694.56RVU25D
2025-07-01$816.70$694.56RVU25C
2025-04-01$816.70$694.56RVU25B
2025-01-01$816.70$694.56RVU25A
2024-10-01$848.81$715.95RVU24D
2024-07-01$848.81$715.95RVU24C
2024-04-01$848.81$715.95RVU24B
2024-03-09$848.81$715.95RVU24AR
2024-01-01$834.96$704.27RVU24A
2023-10-01$878.84$739.61RVU23D
2023-07-01$878.84$739.61RVU23C
2023-04-01$878.84$739.61RVU23B
2023-01-01$878.84$739.61RVU23A
2022-10-01$904.65$757.18RVU22D
2022-07-01$904.65$757.18RVU22C
2022-04-01$904.65$757.18RVU22B
2022-01-01$904.65$757.18RVU22A
2021-10-01$910.86$763.03RVU21D
2021-07-01$910.86$763.03RVU21C
2021-04-01$910.86$763.03RVU21B
2021-01-01$910.86$763.03RVU21A
2020-10-01$894.34$761.15RVU20D
2020-07-01$894.34$761.15RVU20C
2020-04-01$894.34$761.15RVU20B
2020-01-01$894.34$761.15RVU20A
2019-10-01$877.69$753.14RVU19D
2019-07-01$877.69$753.14RVU19C
2019-04-01$877.69$753.14RVU19B
2019-01-01$877.69$753.14RVU19A
2018-10-01$871.88$756.10RVU18D
2018-07-01$871.88$756.10RVU18C
2018-04-01$871.88$756.10RVU18B
2018-01-01$871.88$756.10RVU18AR1
2017-10-01$861.64$749.24RVU17D
2017-07-01$861.64$749.24RVU17C
2017-04-01$861.64$749.24RVU17B
2017-01-01$861.64$749.24RVU17A
2016-10-01$859.40$747.35RVU16D
2016-07-01$859.40$747.35RVU16C
2016-04-01$859.40$747.35RVU16B
2016-01-01$859.40$747.35RVU16A
2015-10-01$862.07$749.62RVU15D
2015-07-01$862.07$749.62RVU15C
2015-04-01$857.78$745.89RVU15B
2015-01-01$857.78$745.89RVU15A
2014-10-01$904.69$793.20RVU14D
2014-07-01$904.69$793.20RVU14C
2014-04-01$904.69$793.20RVU14B
2014-01-01$904.69$793.20RVU14A
2013-10-01$891.38$773.88RVU13D
2013-07-01$891.38$773.88RVU13C
2013-04-01$891.38$773.88RVU13B
2013-01-01$891.38$773.88RVU13AR

Price 67025 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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