No office rate
67108 reports retinal detachment repair with vitrectomy when the case is not complex. 67113 is for complex repair involving vitrectomy and membrane peeling.
On this page
CMS RVU26D · Effective 2026-10-01
67113 Retinal repair Medicare reimbursement rates in Indiana
Reports vitrectomy-based repair of a complex retinal detachment, such as one involving proliferative vitreoretinopathy or diabetic traction. Compare 67113 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 67113 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
$1052.73
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 67113: Complex retinal detachment repair with vitrectomy
Reports vitrectomy-based repair of a complex retinal detachment, such as one involving proliferative vitreoretinopathy or diabetic traction.
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.
CMS billing rules for 67113
- 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 RVU18.53 · 56%
- Practice expense (office) RVU13.24 · 40%
- Malpractice RVU1.47 · 4%
16K
Medicare services in 2024 · #1236 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.
67113 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
67107 describes detachment repair by an approach distinct from the complex vitrectomy-based repair reported with 67113. Select based on the operative method and case complexity.
$315.35
67101 is a cryotherapy-based repair for a less complex detachment situation; 67113 is for complex repair requiring vitrectomy and membrane peeling.
$281.19
67105 is a photocoagulation-based repair for a less complex detachment situation; 67113 reports complex vitrectomy-based repair.
Compare 67113 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
$1052.73
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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 67113 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,435
- Code
- 67113
- Physician work
- 18.53
- Practice expense
- 13.24
- Malpractice
- 1.47
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.53 | × 1.000 | 18.5300 |
| Practice expense | 13.24 | × 0.927 | 12.2735 |
| Malpractice | 1.47 | × 0.486 | 0.7144 |
| Total RVUs | 31.5179 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1052.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.53 | 1 |
| Practice expense | 13.24 | 0.927 |
| Malpractice | 1.47 | 0.486 |
(18.53 × 1 + 13.24 × 0.927 + 1.47 × 0.486) × $33.4009 = $1052.73
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.
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 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.
7,43267107,,Repair detached retina,A,,15.60,11.28,NA,11.28,,1.25,28.13,28.13,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43367108,,Repair detached retina,A,,16.70,11.67,NA,11.67,,1.33,29.70,29.70,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43467110,,Repair detached retina,A,,9.99,15.90,,10.12,,0.80,26.69,20.91,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43567113,,Repair retinal detach cplx,A,,18.53,13.24,NA,13.24,,1.47,33.24,33.24,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43667115,,Release encircling material,A,,5.96,6.51,NA,6.51,,0.47,12.94,12.94,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43767120,,Remove eye implant material,A,,6.92,12.60,,6.79,,0.54,20.06,14.25,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,43867121,,Remove eye implant material,A,,11.94,9.99,NA,9.99,,0.96,22.89,22.89,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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