CPT code 67043: Vitrectomy, preretinal and internal limiting membranes2026 Medicare rate & RVUs in South Carolina

In South Carolina, Medicare pays $968.11 for 67043 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 67043 nationwide

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

What 67043 covers

A vitreoretinal surgeon performs this pars plana vitrectomy to remove a preretinal cellular membrane and the retina’s internal limiting membrane. A common setting is surgery for a macular pucker when the surgeon also peels the internal limiting membrane. The work takes place in an operating room, usually in a facility setting, and may include other operative steps needed to complete the retinal procedure.

Report this code when the operative documentation supports removal of both membrane layers; removal of only the preretinal membrane or only the internal limiting membrane points to a different code. The 90-day global period includes 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 other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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.

How South Carolina compares for 67043

Across 109 of 109 payment localities, the facility rate for 67043 runs from $927.56 in Arkansas to $1,293.56 in Alaska. South Carolina pays $968.11. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

67043 rates by state

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

See 67043 in every payment locality

How the 67043 rate is calculated

Each of 67043’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 67043

67043 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

Codes related to 67043

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

How 67043 has changed in South Carolina

Price 67043 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

• Abbeville
• Abney Crossroads
• Adams Run
• Aiken
• Alcolu
• Allendale
• Anderson
• Andrews

Browse all communities in South Carolina

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