No office rate
Use 67041 when the vitrectomy includes removal of a preretinal cellular membrane. 67036 describes the vitrectomy without that specified membrane-removal service.
On this page
CMS RVU26D · Effective 2026-10-01
67041 Vitrectomy Medicare reimbursement rates in Indiana
Reports pars plana vitrectomy with peeling of a preretinal cellular membrane, typically for symptomatic epiretinal membrane or macular pucker. Compare 67041 office and facility rates across CMS payment localities in Indiana.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 67041 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$905.33
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Retinal surgery
About 67041: Pars plana vitrectomy with membrane peel
Reports pars plana vitrectomy with peeling of a preretinal cellular membrane, typically for symptomatic epiretinal membrane or macular pucker.
A vitreoretinal surgeon removes vitreous through a pars plana approach and peels a cellular membrane from the retinal surface. The procedure is commonly performed for an epiretinal membrane, also called macular pucker, which can distort central vision. It is generally an operating-room procedure, most often in a facility setting.
Report 67041 when the operative service includes vitrectomy and removal of a preretinal cellular membrane; the operative note should identify the membrane and document its removal. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral surgery reported with modifier 50, CMS pays 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 67041
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.92 · 56%
- Practice expense (office) RVU11.40 · 40%
- Malpractice RVU1.27 · 4%
16.3K
Medicare services in 2024 · #1225 by national volume
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.
67041 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
67042 describes removal of the internal limiting membrane, often during macular hole surgery; 67041 describes removal of a preretinal cellular membrane such as an epiretinal membrane.
No office rate
67043 is for removal of a subretinal membrane. 67041 is for removal of a membrane on the retinal surface.
Compare 67041 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
Unavailable
Facility
$905.33
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 67041 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,427
- Code
- 67041
- Physician work
- 15.92
- Practice expense
- 11.40
- Malpractice
- 1.27
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.92 | × 1.000 | 15.9200 |
| Practice expense | 11.40 | × 0.927 | 10.5678 |
| Malpractice | 1.27 | × 0.486 | 0.6172 |
| Total RVUs | 27.1050 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$905.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.92 | 1 |
| Practice expense | 11.4 | 0.927 |
| Malpractice | 1.27 | 0.486 |
(15.92 × 1 + 11.4 × 0.927 + 1.27 × 0.486) × $33.4009 = $905.33
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
67041 billing questions
How is 67041 different from 67042?
67041 describes removal of a preretinal cellular membrane, such as an epiretinal membrane. 67042 is used when the membrane removed is the internal limiting membrane, commonly in macular hole surgery.
Can 67036 be reported separately for the same eye?
No. The vitrectomy is part of 67041, which describes the procedure with removal of the preretinal membrane.
What documentation supports 67041?
The operative report should document the pars plana vitrectomy and removal of a preretinal cellular membrane, such as an epiretinal membrane or macular pucker.
How is bilateral surgery reported?
Report bilateral surgery with modifier 50. CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,42467036,,Removal of inner eye fluid,A,,11.83,9.95,NA,9.95,,0.95,22.73,22.73,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42567039,,Laser treatment of retina,A,,12.87,10.32,NA,10.32,,1.04,24.23,24.23,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42667040,,Laser treatment of retina,A,,14.14,10.77,NA,10.77,,1.13,26.04,26.04,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42767041,,Vit for macular pucker,A,,15.92,11.40,NA,11.40,,1.27,28.59,28.59,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42867042,,Vit for macular hole,A,,15.92,11.39,NA,11.39,,1.27,28.58,28.58,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42967043,,Vit for membrane dissect,A,,16.97,11.77,NA,11.77,,1.34,30.08,30.08,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43067101,,Repair detached retina crtx,A,,3.41,6.37,,3.69,,0.26,10.04,7.36,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915