CPT code 67113: Retinal repair, complex detachment2026 Medicare rate & RVUs in Utah

Reports vitrectomy-based repair of a complex retinal detachment, such as one involving proliferative vitreoretinopathy or diabetic traction.

CMS RVU26DEffective Oct 1, 2026One payment locality16K Medicare services in 2024

In Utah, Medicare pays $1,078.70 for 67113 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,078.70Hospital or facility

Check a contract rate as a % of Medicare · 67113 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 67113 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 67113 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 67113 covers

A vitreoretinal surgeon uses this code for complex retinal detachment repair involving vitrectomy and membrane peeling. Cases may involve proliferative vitreoretinopathy or traction from diabetic retinopathy. Depending on the operative findings, repair may also include draining subretinal fluid, laser or cryotherapy, a scleral buckle, and gas or oil tamponade. These procedures are typically performed in an operating room, most often in a facility setting.

Choose this code when the documented detachment and operative work support a complex repair, rather than a less complex detachment procedure. The operative report should establish the retinal pathology and describe the vitrectomy, membrane work, and other repair steps performed. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 Utah compares for 67113

Across 109 of 109 payment localities, the facility rate for 67113 runs from $1,024.08 in Arkansas to $1,426.40 in Alaska. Utah pays $1,078.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

67113 in Utah vs other payment areas
  1. Utah · this page$1,078.70
  2. Los Angeles, CA · California$1,200.05+$121.35
  3. Washington, DC area · District of Columbia$1,227.93+$149.23
  4. Miami, FL · Florida$1,203.45+$124.75
  5. Chicago, IL · Illinois$1,180.37+$101.67
  6. Manhattan, NY · New York$1,250.27+$171.57
  7. Alaska · Alaska$1,426.40+$347.70

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

Every other payment area

67113 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,033.66
ArkansasArkansas—$1,024.08
ArizonaArizona—$1,089.47
Bakersfield, CACalifornia—$1,145.26
Chico, CACalifornia—$1,140.44
El Centro, CACalifornia—$1,140.68
Fresno, CACalifornia—$1,140.44
Hanford, CACalifornia—$1,140.44

67113 rates by state

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

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.

View every state and territory as a table
67113 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 67113 in every payment locality

How the 67113 rate is calculated

Each of 67113’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 · 67113

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.53

18.53 RVUs× 1.000 GPCI

Practice expense13.24

13.24 RVUs× 1.000 GPCI

Malpractice1.47

1.47 RVUs× 1.000 GPCI

Adjusted RVUs

33.2400

Conversion factor

$33.4009

Medicare rate

$1,110.25

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,435

Code
67113
Physician work
18.53
Practice expense
13.24
Malpractice
1.47

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Facility calculation for 67113 in Utah
ComponentRVULocality factorAdjusted
Physician work18.53× 1.00018.5300
Practice expense13.24× 0.94012.4456
Malpractice1.47× 0.8981.3201
Total RVUs32.2957
Conversion factor× 33.4009

Facility rate, Utah$1078.70

Facility: (18.53 × 1 + 13.24 × 0.94 + 1.47 × 0.898) × $33.4009 = $1078.70

Open 67113 in the RVU calculator

Payment rules and modifiers for 67113

67113 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67113

Retinal repair, complex detachment

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)2Paid.
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 · 67113

Retinal repair, complex detachment

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

67113 without 50 · national facility

$1,110.25

Retinal repair, complex detachment

67113-50 · Bilateral: 150%

$1,665.38

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

How 67113 has changed in Utah

67113 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,078.70RVU26D
2026-07-01Not available in this setting$1,078.70RVU26C
2026-04-01Not available in this setting$1,078.70RVU26B
2026-01-01Not available in this setting$1,078.70RVU26A
2025-10-01Not available in this setting$1,226.17RVU25D
2025-07-01Not available in this setting$1,226.17RVU25C
2025-04-01Not available in this setting$1,226.17RVU25B
2025-01-01Not available in this setting$1,226.17RVU25A
2024-10-01Not available in this setting$1,263.71RVU24D
2024-07-01Not available in this setting$1,263.71RVU24C
2024-04-01Not available in this setting$1,263.71RVU24B
2024-03-09Not available in this setting$1,263.71RVU24AR
2024-01-01Not available in this setting$1,243.08RVU24A
2023-10-01Not available in this setting$1,268.39RVU23D
2023-07-01Not available in this setting$1,268.39RVU23C
2023-04-01Not available in this setting$1,268.39RVU23B
2023-01-01Not available in this setting$1,268.39RVU23A
2022-10-01Not available in this setting$1,269.35RVU22D
2022-07-01Not available in this setting$1,269.35RVU22C
2022-04-01Not available in this setting$1,269.35RVU22B
2022-01-01Not available in this setting$1,269.35RVU22A
2021-10-01Not available in this setting$1,279.03RVU21D
2021-07-01Not available in this setting$1,279.03RVU21C
2021-04-01Not available in this setting$1,279.03RVU21B
2021-01-01Not available in this setting$1,279.03RVU21A
2020-10-01Not available in this setting$1,316.63RVU20D
2020-07-01Not available in this setting$1,316.63RVU20C
2020-04-01Not available in this setting$1,316.63RVU20B
2020-01-01Not available in this setting$1,316.63RVU20A
2019-10-01Not available in this setting$1,333.17RVU19D
2019-07-01Not available in this setting$1,333.17RVU19C
2019-04-01Not available in this setting$1,333.17RVU19B
2019-01-01Not available in this setting$1,333.17RVU19A
2018-10-01Not available in this setting$1,336.13RVU18D
2018-07-01Not available in this setting$1,336.13RVU18C
2018-04-01Not available in this setting$1,336.13RVU18B
2018-01-01Not available in this setting$1,336.13RVU18AR1
2017-10-01Not available in this setting$1,324.95RVU17D
2017-07-01Not available in this setting$1,324.95RVU17C
2017-04-01Not available in this setting$1,324.95RVU17B
2017-01-01Not available in this setting$1,324.95RVU17A
2016-10-01Not available in this setting$1,384.17RVU16D
2016-07-01Not available in this setting$1,384.17RVU16C
2016-04-01Not available in this setting$1,384.17RVU16B
2016-01-01Not available in this setting$1,384.17RVU16A
2015-10-01Not available in this setting$1,722.14RVU15D
2015-07-01Not available in this setting$1,722.14RVU15C
2015-04-01Not available in this setting$1,713.57RVU15B
2015-01-01Not available in this setting$1,713.57RVU15A
2014-10-01Not available in this setting$1,778.09RVU14D
2014-07-01Not available in this setting$1,778.09RVU14C
2014-04-01Not available in this setting$1,778.09RVU14B
2014-01-01Not available in this setting$1,778.09RVU14A
2013-10-01Not available in this setting$1,743.10RVU13D
2013-07-01Not available in this setting$1,743.10RVU13C
2013-04-01Not available in this setting$1,743.10RVU13B
2013-01-01Not available in this setting$1,743.10RVU13AR

Price 67113 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

67113 billing questions

When should 67113 be chosen over 67108?

Use 67113 when the detachment is complex and the operative work supports vitrectomy with membrane peeling. Use 67108 for a detachment repair with vitrectomy when the case does not meet the complex-repair criteria.

What operative details support 67113?

Document the pathology establishing complexity, such as proliferative vitreoretinopathy or diabetic traction, and the vitrectomy and membrane work performed. Include other repair steps, such as drainage, laser, buckle, or tamponade, when performed.

Are gas or oil tamponade and laser separately reported as part of the repair?

These may be steps in the retinal repair represented by 67113. The operative report should describe the steps performed as part of the complex repair.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period for 67113.

How are bilateral repairs and multiple same-session procedures handled?

Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

Can an assistant or co-surgeon be reported for 67113?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; 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 67113PPRRVU2026_Oct_nonQPP.csv, line 7,435 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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