Billing code 67005: VitrectomyMedicare rate & RVUs in Washington
Reports partial removal of vitreous through an anterior approach, commonly when vitreous prolapses into the front of the eye during surgery.
CMS doesn’t publish an office rate for 67005 in Washington.
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 67005 covers
An ophthalmic surgeon uses an anterior approach to remove part of the vitreous gel, often to clear vitreous that has moved into the anterior chamber during cataract surgery. The service is performed in an operative setting when the surgeon documents that partial vitreous removal was needed; it is distinct from a pars plana vitrectomy directed at the posterior segment.
Choose this code for partial removal by the anterior approach, rather than a more extensive removal or a different approach. The operative note should identify the vitreous prolapse or other indication, the approach, and the removal performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; 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 67005 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $423.36 |
| Seattle (King Cnty) | Unavailable | $467.27 |
How the 67005 rate is calculated
Each of 67005’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 · 67005
RVUs × geographic indexes × conversion factor
Work5.74
5.74 RVUs× 1.000 GPCI
Practice expense6.19
6.19 RVUs× 1.000 GPCI
Malpractice0.45
0.45 RVUs× 1.000 GPCI
Adjusted RVUs
12.3800
Conversion factor
$33.4009
Medicare rate
$413.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67005
67005 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67005
Vitrectomy
| 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 · 67005
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67005 without 50 · national facility
$413.50
Vitrectomy
67005-50 · Bilateral: 150%
$620.25
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).
67005 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67010Anterior vitrectomy
- Both use an anterior approach, but 67005 describes partial removal while 67010 is selected for subtotal removal.
- 67015Choroidal drainage
- 67015 involves aspiration or release by a pars plana approach; 67005 is partial removal through an anterior approach.
- 67036Vitrectomy
- 67036 is mechanical vitreous removal through a pars plana approach, generally for posterior-segment work; 67005 is partial removal through the front of the eye.
67005 billing questions
How is 67005 distinguished from 67010?
Both describe anterior-approach vitreous removal. Use 67005 for partial removal and 67010 when the operative work is subtotal.
When is 67005 used during cataract surgery?
A common situation is vitreous prolapse into the anterior chamber during cataract surgery, requiring partial removal. The operative note should document the vitreous problem and the removal performed.
Can 67005 be reported with another procedure in the same session?
The code represents partial anterior vitreous removal, not routine cataract extraction. If multiple procedures are payable in the same session, Medicare applies its multiple-procedure reduction: the highest-valued procedure is paid in full and the others at 50%.
What modifier applies when both eyes are treated?
For bilateral performance, report modifier 50; Medicare pays the bilateral procedure at 150%.
Does 67005 have a global period?
Yes. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care during the 90 days.
Can an assistant or co-surgeon be paid for 67005?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeon payment requires 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
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