# CPT 67042

> Medicare paid $1,182.59 for CPT 67042 in the office (non-facility) setting and $1,182.59 in a facility under the Q4 2018 Physician Fee Schedule, effective October 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2018, when it increased 0.8%.

## What it is

Vitrectomy combined with peeling away the internal limiting membrane, the glass-clear innermost layer covering the surface of the retina. Once the vitreous gel is out, the surgeon stains that microscopically thin layer with dye and lifts it off the macula with fine forceps, releasing the pull that is distorting central vision, then often leaves a gas bubble in the eye to hold things in place while healing occurs. What separates this from its close sibling is which layer comes off: the retina's own surface membrane here, rather than a scar membrane growing on top of the retina.

## Selected release

- Release: Q4 2018 (2018 D)
- Effective: October 1 – December 31, 2018
- Status indicator: A
- Office (non-facility) national allowed amount: $1182.59
- Facility national allowed amount: $1182.59
- Sequestration: not applied

## RVUs and formula

- Work RVU: 16.33
- Office (non-facility) practice expense RVU: 15.34
- Facility practice expense RVU: 15.34
- Malpractice RVU: 1.18
- Conversion factor: 35.9996
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2018)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18d.zip
- Parsed file: PPRRVU18_OCT.csv, row 11,285
- Canonical page: https://localishealth.com/cpt/67042/2018/A
- Release-specific citation URL: https://localishealth.com/cpt/67042/2018/D
- Last significant update: 2026-08-04T03:08:37+00:00