Billing code 67025: Vitreous exchangeMedicare rate & RVUs in Guam
Reports aspiration of vitreous followed by placement of a vitreous substitute, commonly for a retinal condition requiring fluid-gas exchange.
Medicare pays $796.47 for 67025 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
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.
67025 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $796.47 | $566.33 |
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
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.
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
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 67025
Vitreous exchange
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
67025 without 50 · national office
$742.50
Vitreous exchange
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).
67025 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67015Choroidal drainage
- 67015 describes aspiration or release of vitreous. Choose 67025 when the procedure also introduces a vitreous substitute.
- 67036Vitrectomy
- 67036 is mechanical pars plana vitrectomy. Choose 67025 for aspiration with substitute placement rather than mechanical vitreous removal as the principal service.
- 67028Intravitreal injection
- 67028 reports an intravitreal pharmacologic injection. It does not describe exchanging vitreous with a substitute.
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
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