Find policies, billing codes, payers, states, and providers
CPT 67036: Pars Plana Vitrectomy for Posterior Segment Access
CPT code 67036 represents a pars plana vitrectomy — the surgical removal of vitreous gel to access the posterior segment of the eye and introduce instruments for retinal and vitreoretinal interventions. This procedure is a high-acuity ophthalmic surgery with national relevance because it is central to managing retinal detachments, vitreous hemorrhage, macular disease, and other sight-threatening conditions that require surgical access to the posterior segment.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and the typical sites of service (hospital operating rooms and ambulatory surgery centers), plus operational benchmarks and policy-relevant items where available. The publication outlines billing and coding considerations specific to CPT code 67036, common modifier usage, and practical notes on service lines for ophthalmology and surgical departments.
This summary equips billing managers, surgical administrators, and policy analysts with the essentials for understanding how CPT code 67036 is used in clinical practice, what types of services it represents, and which national payers are commonly involved. Data not available in the input will be noted where relevant in subsequent sections.
Customize your policy alerts
Sign up for cpt 67036 policy alerts
Get alerted when payer policies referencing 67036 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 67036 describes a surgical procedure in which the provider removes vitreous fluid from the eye (vitrectomy) to access the posterior segment and introduce surgical instruments through incisions in the pars plana. This procedure is a posterior segment ophthalmic surgery used to treat a range of retinal and vitreous conditions.
Service Type: Surgical — Posterior Segment Vitrectomy
Typical Site of Service: Hospital operating room or ambulatory surgery center (ophthalmic surgical suite)
Data not available in the input.