CPT code 67036: Vitrectomy, pars plana approach2026 Medicare rate & RVUs in Missouri
Mechanical removal of vitreous gel through a pars plana approach, commonly performed by a retinal surgeon for vitreous hemorrhage or other vitreous pathology.
CMS doesn’t publish an office rate for 67036 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 67036 covers
An ophthalmologist, usually a vitreoretinal surgeon, uses an intraocular cutter introduced through the pars plana to remove vitreous gel. The operation is performed in an operating room, commonly for dense vitreous hemorrhage or other vitreous pathology requiring surgical clearance. The surgeon may also address retinal disease during the same operation; when the service includes a specifically described retinal procedure, code selection should reflect the full operative work rather than vitreous removal alone.
Report 67036 when documentation supports mechanical vitreous removal by the pars plana route; distinguish it from anterior-approach removal and from codes describing vitrectomy with specific retinal treatment. The operative report should identify the indication, approach, mechanical technique, extent of removal, and additional retinal procedures. CMS assigns a 90-day major-surgery global, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral surgery reported with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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 67036 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $738.20 |
| Metropolitan St. Louis, MO | Unavailable | $743.31 |
| Rest of Missouri | Unavailable | $712.51 |
How the 67036 rate is calculated
Each of 67036’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 · 67036
RVUs × geographic indexes × conversion factor
Work11.83
11.83 RVUs× 1.000 GPCI
Practice expense9.95
9.95 RVUs× 1.000 GPCI
Malpractice0.95
0.95 RVUs× 1.000 GPCI
Adjusted RVUs
22.7300
Conversion factor
$33.4009
Medicare rate
$759.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67036
67036 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67036
Vitrectomy, pars plana approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67036
Vitrectomy, pars plana 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67036 without 50 · national facility
$759.20
Vitrectomy, pars plana approach
67036-50 · Bilateral: 150%
$1,138.80
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).
67036 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67005VitrectomyPartial, anterior approach
- 67005 describes partial vitreous removal by an anterior approach. Use 67036 when the documented mechanical removal is performed through the pars plana.
- 67041VitrectomyPreretinal membrane removal
- 67041 describes vitrectomy with preretinal membrane removal. Use 67036 when the operation is mechanical vitreous removal without that specifically described membrane work.
- 67042Retinal surgeryInternal limiting membrane peel
- 67042 describes vitrectomy with internal limiting membrane removal, commonly in macular hole surgery. 67036 identifies pars plana mechanical vitreous removal without that added membrane procedure.
67036 billing questions
When should 67036 be chosen over 67041, 67042, or 67043?
Use 67036 for mechanical vitreous removal through the pars plana when the operation is not described by a more specific vitrectomy code for membrane or macular work. Choose the code that matches the documented retinal work.
Can retinal treatment be reported with 67036?
A separately performed retinal service may have its own code when coding requirements are met. Do not separately report 67036 for work already represented by a more specific combined vitrectomy code.
What is included in the global period?
The 90-day major-surgery global includes the day-before preoperative visit and related postoperative care through day 90.
How is bilateral surgery reported?
For bilateral surgery reported with modifier 50, CMS payment is 150%.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What operative details support 67036?
Document the vitreous indication, pars plana approach, use of mechanical removal, extent of the work, and any additional retinal procedures 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
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