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Billing code 67036: VitrectomyMedicare rate & RVUs

Mechanical removal of vitreous gel through a pars plana approach, commonly performed by a retinal surgeon for vitreous hemorrhage or other vitreous pathology.

CMS RVU26DEffective Oct 1, 2026109 payment localities34.2K Medicare services in 2024

Medicare pays $759.20 for 67036 nationally in a facility.

Medicare rate · 67036

Vitrectomy

Swap in your local Medicare rate.

Work RVUs
11.83
Total RVUs
22.73
Global days
090

National rate · 2026

$759.20

Facility setting, before claim adjustments.

See every locality for 67036 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 67036 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

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

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

67036 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$703.89
Alaska*Unavailable$964.12
ArizonaUnavailable$744.33
ArkansasUnavailable$696.95
AtlantaUnavailable$772.08
AustinUnavailable$775.65
BakersfieldUnavailable$786.21
Baltimore/Surr. CntysUnavailable$797.31
BeaumontUnavailable$727.04
BrazoriaUnavailable$752.39

67036 rates by state

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

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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
67036 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

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

Swap in your local Medicare rate.

Work 11.83Practice expense 9.95Malpractice 0.95

22.7300 adjusted RVUs×$33.4009 conversion factor=$759.20

All indexes start 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

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 · 67036

Vitrectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

67036 without 50 · national facility

$759.20

Vitrectomy

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).

When to use modifier 50

67036 compared with similar codes

Compare codes

67036 vs 67005 vs 67041 vs 67042: national Medicare rates

Swap in your local Medicare rate.

  • 67036
    Vitrectomy · 11.83 wRVU
    —
  • 67005
    Vitrectomy · 5.74 wRVU
    —
  • 67041
    Vitrectomy · 15.92 wRVU
    —
  • 67042
    Retinal surgery · 15.92 wRVU
    —

How to choose

67005Vitrectomy
67005 describes partial vitreous removal by an anterior approach. Use 67036 when the documented mechanical removal is performed through the pars plana.
67041Vitrectomy
67041 describes vitrectomy with preretinal membrane removal. Use 67036 when the operation is mechanical vitreous removal without that specifically described membrane work.
67042Retinal surgery
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.

Codes related to 67036

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

Codes related to 67036
CodeHow it relatesNational office range
Used instead
67005VitrectomyAnterior-approach partial vitreous removal rather than pars plana vitrectomy.No office rate
67010Anterior vitrectomyAnterior-approach subtotal mechanical vitreous removal.No office rate
Same family
67040Retinal vitrectomyVitrectomy with extensive endolaser treatment of the retina.No office rate
67041VitrectomyVitrectomy with removal of a preretinal membrane, such as a macular pucker.No office rate
67042Retinal surgeryVitrectomy with internal limiting membrane removal, commonly for macular hole surgery.No office rate
67043VitrectomyVitrectomy with removal of a subretinal membrane.No office rate

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

Show the CMS file lines behind this rate
RVUs for 67036PPRRVU2026_Oct_nonQPP.csv, line 7,424 (RVU26D)

Open CMS sourceHow we calculate rates

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