No office rate
67005 describes partial vitreous removal by an anterior approach. Use 67036 when the documented mechanical removal is performed through the pars plana.
On this page
CMS RVU26D · Effective 2026-10-01
67036 Vitrectomy Medicare reimbursement rates in Wyoming
Mechanical removal of vitreous gel through a pars plana approach, commonly performed by a retinal surgeon for vitreous hemorrhage or other vitreous pathology. Compare 67036 office and facility rates across CMS payment localities in Wyoming.
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 67036 in Wyoming?
Wyoming 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
$750.95
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Ophthalmic surgery
About 67036: Pars plana mechanical vitrectomy
Mechanical removal of vitreous gel through a pars plana approach, commonly performed by a retinal surgeon for vitreous hemorrhage or other vitreous pathology.
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.
CMS billing rules for 67036
- 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 RVU11.83 · 52%
- Practice expense (office) RVU9.95 · 44%
- Malpractice RVU0.95 · 4%
34.2K
Medicare services in 2024 · #927 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.
67036 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
67041 describes vitrectomy with preretinal membrane removal. Use 67036 when the operation is mechanical vitreous removal without that specifically described membrane work.
No office rate
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.
Compare 67036 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$750.95
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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 67036 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,424
- Code
- 67036
- Physician work
- 11.83
- Practice expense
- 9.95
- Malpractice
- 0.95
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.83 | × 1.000 | 11.8300 |
| Practice expense | 9.95 | × 1.000 | 9.9500 |
| Malpractice | 0.95 | × 0.740 | 0.7030 |
| Total RVUs | 22.4830 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$750.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.83 | 1 |
| Practice expense | 9.95 | 1 |
| Malpractice | 0.95 | 0.74 |
(11.83 × 1 + 9.95 × 1 + 0.95 × 0.74) × $33.4009 = $750.95
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.
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 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.
7,42167028,,Injection eye drug,A,,1.40,1.91,,0.75,,0.11,3.42,2.26,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42267030,,Incise inner eye strands,A,,5.96,8.27,NA,8.27,,0.47,14.70,14.70,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42367031,,Laser surgery eye strands,A,,4.36,6.96,,4.44,,0.35,11.67,9.15,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,42467036,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,