67042

👁️ CPT 67042 — Vitrectomy, Mechanical, Pars Plana Approach; With Removal of Internal Limiting Membrane of Retina (e.g., for Repair of Macular Hole, Diabetic Macular Edema), Includes, if Performed, Intraocular Tamponade

Billable Code Confirmed

CPT 67042 is a valid, billable 5-digit CPT procedure code for FY2026. The first four characters (6704) define the vitrectomy family with pars plana approach; the fifth character (2) specifies the additional steps of internal limiting membrane removal and possible intraocular tamponade. No additional characters are required.

Non-Billable Parent Codes — Never Submit These

• ❌ 67036 — Vitrectomy, mechanical, pars plana approach (basic vitrectomy without ILM peel or tamponade). Lacks the ILM removal and tamponade components that define 67042.
• ❌ 67041 — Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (e.g., macular pucker). Targets a different membrane (epiretinal membrane, not ILM) — submitting this for an ILM peel misrepresents the procedure.
• ❌ 67039 — Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation. Captures ILM laser, not ILM peel — coded for different pathology.

Always submit 67042 (all 5 characters) when the operative note documents removal of the internal limiting membrane for macular hole repair or diabetic macular edema with possible tamponade.

Clinical Context: Key Distinction

CPT 67042 captures the specific combination of (1) core vitrectomy, (2) internal limiting membrane peel, and (3) optional intraocular tamponade placement. The critical distinction from sibling codes is the membrane target: 67041 peels the preretinal cellular membrane (epiretinal membrane/macular pucker), while 67042 peels the internal limiting membrane of the retina — a thinner, more adherent layer at the vitreoretinal interface. This distinction is driven entirely by the documented membrane identity in the operative note. Mislabeling the membrane results in a coding error that may trigger payer review.

Code Classification

CPT Procedure Code — wRVU, global period, and practice expense values apply. This is a surgical procedure code reported on the Medicare Physician Fee Schedule (MPFS). See the ICD-10-CM Diagnosis Crosswalk section for associated conditions and the ICD-10-PCS Crosswalk section for inpatient facility equivalents.

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🔍 Code Description

CPT 67042 classifies a vitreoretinal surgical procedure in which the surgeon performs a mechanical pars plana vitrectomy (removal of the vitreous humor using a mechanical cutting instrument) and peels the internal limiting membrane (ILM) of the retina. The procedure may conclude with the injection of an intraocular tamponade agent — air, gas (commonly SF₆ or C₃F₈), or silicone oil — to press the retina against the retinal pigment epithelium and promote reattachment or macular hole closure.

The ILM is the innermost basement membrane of the retina, directly adjacent to the vitreous cavity. Peeling it removes residual vitreous cortex, reduces tangential and anteroposterior traction on the macula, and promotes glial proliferation that aids macular hole closure or reduces **macular edem**a. The procedure is performed through three small sclerotomies (typically 23-, 25-, or 27-gauge) placed in the pars plana, ~3.5-4.0 mm posterior to the limbus.

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🌳 Code Tree / Hierarchy

Surgery on the Eye and Ocular Adnexa (65-68)
│
├── 67000-67027 — Anterior Segment Procedures
│
└── 67036-67043 — Posterior Segment: Vitreous Procedures
    │
    ├── [[67036]]   Vitrectomy, mechanical, pars plana approach  (Global: 000)
    ├── [[67039]]   Vitrectomy + focal endolaser photocoagulation  (Global: 000)
    ├── [[67040]]   Vitrectomy + endolaser panretinal photocoagulation  (Global: 000)
    ├── [[67041]]   Vitrectomy + removal of preretinal cellular membrane (ERM/Macular Pucker)  (Global: 000)
    ├── ▶▶ [[67042]]   Vitrectomy + removal of ILM of retina ± intraocular tamponade  ◀ THIS CODE  (Global: 000)
    ├── [[67043]]   Vitrectomy + removal of subretinal membrane ± tamponade ± laser  (Global: 000)
    │
    └── 67121 (bundled) — Removal of implanted material, posterior segment
                         (includes silicone oil removal)

Note: ALL codes 67036-67043 are NCCI-bundled when performed on the
same eye in the same session. Report the HIGHEST-RVU code only.

Specificity & Code Selection

The selection axis between 67036 and 67042 is membrane identity and surgical intent — not technique. The vitrectomy component is identical across the family; what changes is (1) what membrane is peeled, (2) whether endolaser is applied, and (3) whether tamponade is used. When the operative note documents ILM peel specifically (e.g., “ILM was stained with ICG/brilliant blue and peeled in a continuous curvilinear fashion”), 67042 is the correct code regardless of whether tamponade was ultimately placed.

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✅ Includes

The following procedures and steps are bundled into CPT 67042 and are NOT separately reportable:

• Pars plana vitrectomy (core vitreous removal)
• Induction of posterior vitreous detachment (PVD) if performed
• ILM staining with vital dye (e.g., ICG, brilliant blue G, triamcinolone)
• ILM peeling with intraocular forceps/membrane pick
• Core vitrectomy and peripheral vitreous base shaving
• Fluid-air exchange
• Intraocular tamponade injection (air, gas such as C₃F₈ or SF₆, or silicone oil) — if performed
• Endodiathermy or endolaser for hemostasis at peel site (incidental to the ILM peel)
• Standard postoperative subconjunctival antibiotic/corticosteroid injection

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❌ Excludes / Do Not Report Together

Excludes 1 — Cannot Be Coded Simultaneously with 67042 (Same Eye, Same Session)

Code	Description	Note
67036	Vitrectomy, mechanical, pars plana approach (basic)	Mutually exclusive per NCCI. 67036 is always bundled when 67042 is performed; report 67042 only.
67039	Vitrectomy + focal endolaser photocoagulation	NCCI-bundled (indicator 1). If both ILM peel AND focal laser are documented, report 67042 (higher RVU) — the laser is bundled. Unbundling with -59 is rarely justified.
67040	Vitrectomy + panretinal laser photocoagulation	NCCI-bundled. PRP + ILM peel in same eye/session → report whichever code captures the primary surgical goal. If ILM peel is the focus, use 67042.
67041	Vitrectomy + removal of preretinal cellular membrane (macular pucker)	NCCI-bundled. Different target membrane. Use 67041 for ERM/macular pucker; use 67042 for ILM peel. Never report both in the same eye/session.
67043	Vitrectomy + subretinal membrane removal ± laser ± tamponade	NCCI-bundled. Different membrane target (subretinal, e.g., CNV).
67121	Removal of implanted material, posterior segment (e.g., silicone oil)	NCCI-bundled with vitrectomy family. Report the vitrectomy code only (e.g., 67042 for ILM peel).
20902	Bone graft, major or large (orthopedic)	Not ophthalmology, but included for cross-specialty clarity — never billable on the same date if both are same patient/session without distinct operative fields and clinical justification.

Excludes 1 Violation Risk

The most common coding error for 67042 is submitting it alongside 67036 or 67039 on the same claim for the same eye and date of service. Automated NCCI edits will deny the lower-RVU code. Fix: Review the operative note, identify which membrane was peeled (ILM vs. ERM vs. subretinal), which laser was used (focal vs. panretinal vs. none), and submit only the highest-RVU code that accurately captures the primary surgical objective. When multiple procedures are documented, the one that addresses the primary indication listed on the claim should determine the primary CPT code.

Excludes 2 — May Be Coded in Addition if Separately Documented

Code	Description	When It May Be Reported
66984	Extracapsular cataract removal with IOL (same eye)	If cataract surgery is performed in the contralateral eye during the same session, it may be separately coded. In the same eye, cataract is typically addressed after vitrectomy in a staged fashion. Query if both appear on same eye/same day.
66986	Intracapsular cataract removal with IOL (same eye)	Same rules as above; separately reportable only if different eye or staged different session with documented medical necessity.
67210	Destruction of localized lesion of retina (e.g., photocoagulation for DME)	If focal/grid laser for DME is performed in a separate session from vitrectomy, it is separately reportable. In the same session as 67042, laser is bundled; use 67042 alone.
67028	Intravitreal injection of medication	May be reported separately (different procedure, different target) if performed on a different date or in a different eye during the same session.
E/M codes (992xx)	Office visit	Separately reportable only when modifier -25 is appended to the E/M code, documenting a significant, separately identifiable evaluation beyond the routine pre-/post-operative assessment.

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📋 Clinical Overview

Comparison of Vitrectomy Code Family (67036-67043)

These codes represent a single surgical operation (pars plana vitrectomy) with incremental steps. NCCI bundles them — report only the highest code that matches what was performed:

Code	Key Feature Added	Primary Indication	Approx. wRVU
67036	Basic vitrectomy	Vitreous hemorrhage, diagnostic vitrectomy	18.66
67039	+ Focal endolaser	Focal retinal lesions (tears, DME)	~20.07
67040	+ Panretinal laser	Proliferative diabetic retinopathy	~20.78
67041	+ Preretinal membrane (ERM) peel	Macular pucker / epiretinal membrane	~20.23
67042 ◀	+ ILM peel ± tamponade	Macular hole, DME	~20.48
67043	+ Subretinal membrane removal + laser ± tamponade	Choroidal neovascularization, PVR	~21.28

CDI Query Trigger — "What Membrane Was Peeled?"

When the operative note states “membrane peel” without specifying whether the preretinal cellular membrane (→ 67041) or internal limiting membrane (→ 67042) was removed, a CDI query is required. The distinction drives both code selection and clinical accuracy. Key language to elicit: “Was the peel performed at the vitreoretinal interface (ILM) or on the retinal surface (ERM)?” ILM peels are typically stained with vital dyes (ICG, brilliant blue) and peeled in a circumferential fashion around the fovea, while ERM peels are removed as a visible sheet over the macular surface.

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💊 Common Diagnoses / Clinical Indications

Conditions most commonly associated with CPT 67042:

• Full-thickness macular hole (FTMH): Most common indication. ILM peel relieves tangential traction and promotes hole closure. Document hole stage (II, III, or IV per Gass/updated classification), size, and chronicity.
• Diabetic macular edema (DME) refractory to anti-VEGF therapy: ILM peel in DME aims to relieve ILM traction on the Müller cells and improve fluid resorption. Typically performed after failure of ≥3 anti-VEGF injections.
• Vitreomacular traction (VMT) syndrome with macular thickening: ILM peel may be performed when persistent VMT causes progressive visual loss.
• Epiretinal membrane (ERM) with ILM involvement: When ERM recurs or ILM is suspected to be contributing to persistent macular edema after ERM peel.

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💰 RVU & Reimbursement Profile

Component	Value
Work RVU (wRVU)	~20.48 (verify against current CMS MPFS for CY 2026 — subject to the -2.5% efficiency adjustment if not exempted as a time-based code)
Practice Expense RVU (Non-Facility)	~10.71
Practice Expense RVU (Facility)	~5.36 (estimated; reduced per CY 2026 PE allocation rules)
Malpractice RVU	~1.52
Total RVU (Non-Facility)	~32.71
Total RVU (Facility)	~27.36
Global Period	000 (same day)
2026 Medicare CF	~$33.40
Est. Non-Facility Payment	~$1,092 (2025 reference; verify 2026 rate)
Est. Facility Payment	~$914 (2025 reference; verify 2026 rate)
Bilateral Indicator	0 — each eye coded separately with -RT or -LT; no bilateral reduction
Assistant Surgeon	❌ Generally not payable for vitrectomy; rarely used in this subspecialty
Co-Surgeon	❌ Not typically applicable
PC/TC Split	0 — Procedure code only
Modifier -51 Exempt	❌ No — subject to multiple-procedure reduction when billed with other procedures
Anesthesia	Typically monitored anesthesia care (MAC) or general; separately billable (00142, 99100-99150 as applicable)

Place-of-Service Impact

Payment for 67042 differs significantly between non-facility (office/ASC) and facility (hospital outpatient) settings due to reduced facility PE RVUs. ASC payment may be further subject to ASC rate center caps. Always confirm the applicable ASC covered procedures list — vitrectomy codes are generally on the Medicare ASC covered list.

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🏷️ Modifier Reference

Modifier	Name	When to Apply with 67042
-RT	Right Eye	Graft/procedure performed on the right eye
-LT	Left Eye	Graft/procedure performed on the left eye
-50	Bilateral Procedure	Both eyes in the same session; note bilateral indicator = 0, so -50 may be accepted by some payers instead of separate -RT/-LT lines — confirm payer preference
-51	Multiple Procedures	When 67042 is performed alongside other procedures on the same day (e.g., cataract surgery in the contralateral eye); apply to the lower-RVU procedure
-59	Distinct Procedural Service	When another procedure performed the same day is bundled by NCCI with 67042 but represents a distinct service (e.g., separate eye, separate lesion); requires documentation of distinct anatomic site, separate incision, or independent clinical necessity
-25	Significant, Separately Identifiable E/M	Applied to the E/M code — not 67042 — when a separately identifiable office visit occurs on the same date as the vitrectomy
-78	Unplanned Return to OR	Return to OR during the postoperative period for a complication (e.g., postoperative hemorrhage, retinal detachment following vitrectomy); note: 67042 has a 000 global, so -78 would apply to the adjunctive procedure, not the vitrectomy itself
-79	Unrelated Procedure During Postop Period	Unrelated procedure performed during another procedure’s global window

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🩺 Common ICD-10-CM Pairings

Primary Diagnosis Grouping — Macular Hole

ICD-10 Code	Description	Laterality	HCC?	Clinical Notes
H35.341	Full-thickness macular hole, stage II or less	Right eye	—	Primary pairing for right-eye vitrectomy with ILM peel; document stage, size, and duration
H35.342	Full-thickness macular hole, stage II or less	Left eye	—	Mirror code for left eye; same documentation requirements
H35.343	Full-thickness macular hole, stage III	Right eye	—	Use when documented as stage III (large, partially herniated through retinal pigment epithelium)
H35.344	Full-thickness macular hole, stage III	Left eye	—	Stage III left eye variant

Secondary Diagnosis Grouping — Diabetic Macular Edema

ICD-10 Code	Description	Laterality	HCC?	Clinical Notes
E11.321	Type 2 diabetes mellitus with diabetic macular edema	Right eye	✅ HCC 72 (Diabetic Complications) ~RAF 0.322	ILM peel for DME when anti-VEGF has failed; capture annually for RAF
E11.322	Type 2 diabetes mellitus with diabetic macular edema	Left eye	✅ HCC 72 ~RAF 0.322	Mirror code; same capture requirements
E11.36	Type 2 diabetes mellitus with diabetic cataracts	—	✅ HCC 72	May be listed as secondary when cataract coexists with vitrectomy indication

Other Indications

ICD-10 Code	Description	HCC?	Clinical Notes
H35.371	Other macular degeneration, right eye	—	Use only when macular hole staging is absent or the pathology is non-hole macular disease
H35.372	Other macular degeneration, left eye	—	Mirror of right-eye variant
H35.311	Retinoschisis and retinal detachment without macular involvement, right eye	—	When vitrectomy target is retinoschisis rather than macular hole
[[H43.11]**	Vitreous hemorrhage, right eye	—	When vitrectomy is primarily for non-clearing vitreous hemorrhage; may warrant 67036 instead of 67042 if no ILM peel is performed

Coding Specificity Reminder

All ICD-10-CM codes for macular conditions require maximum specificity: document the exact stage of macular hole (II, III, IV), eye laterality, and whether edema is center-involving or center-involving cystoid. ICD-10-CM specificity requirements are not optional — query the provider when the operative note refers to “macular problem” or “macular pathology” without staging or laterality. Always capture the laterality-specific code; an unspecified code (e.g., H35.34 without the 5th/6th character) is a compliance risk.

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🏥 MS-DRG Considerations (Inpatient)

Inpatient Coding Reminder

CPT 67042 is performed exclusively in the outpatient setting (ASC or hospital outpatient department). There is no routine inpatient admission for vitrectomy with ILM peel. If a patient admitted for an unrelated inpatient condition (e.g., stroke, cardiac event) undergoes vitrectomy during the same hospitalization, CPT 67042 would be reported as an additional procedure with minimal DRG weight impact. No MDC or DRG assignment is driven by this code in standard practice. See the ICD-10-PCS Crosswalk below for completeness in the inpatient scenario.

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🔧 ICD-10-PCS Equivalents (Inpatient Facility Coding)

Note

These PCS codes are applicable only when pars plana vitrectomy with ILM peel is performed during an inpatient admission and must be captured for DRG completeness. In the outpatient setting (the vast majority of cases), CPT 67042 is the correct code. PCS root operation selection: “Drainage” is used for removal of vitreous (a gel/fluid substance); the approach character varies by technique (percutaneous for modern sutureless 23-27-gauge PPV, open for older 20-gauge techniques).

PCS Code	Full Description	Technique
08BL3ZZ¹	Drainage of vitreous body, right eye, percutaneous approach	23-27 gauge sutureless PPV
08BL*4Z¹	Drainage of vitreous body, left eye, percutaneous approach	23-27 gauge sutureless PPV
08BL0ZZ¹	Drainage of vitreous body, right eye, open approach	Traditional 20-gauge sutured PPV
08BL*1Z¹	Drainage of vitreous body, left eye, open approach	Traditional 20-gauge sutured PPV

PCS Character Analysis — 08BL3ZZ

Position	Character	Value	Definition
1	Section	0	Medical and Surgical
2	Body System	8	Eye
3	Root Operation	B	Drainage — taking or letting out of fluids and/or gases from a body part
4	Body Part	L	Vitreous body
5	Approach	3	Percutaneous — entry made by a puncture or minor incision through skin or mucous membrane using a needle, trocar, cannula, or other instrument
6	Device	Z	No Device
7	Qualifier	Z	No Qualifier

PCS Notes

• ILM peel in PCS: The internal limiting membrane peel is generally considered part of the vitrectomy bundle and is NOT coded as a separate PCS root operation, consistent with how CPT 67042 bundles ILM peel into the primary code.
• Tamponade in PCS: Intraocular gas or air injection may be coded separately depending on facility practice and whether it is captured within the vitrectomy code. Silicone oil injection for long-term tamponade (e.g., 08B97ZZ — Replacement of vitreous with silicone oil) may be reported when explicitly performed as a distinct step.
• Bilateral PPV: Unlike CPT (which uses -RT/-LT), PCS has no bilateral modifier — assign separate PCS code lines for each eye treated.
• ¹ The exact body part character (position 4) for vitreous may vary by PCS edition and facility coding practice. Verify against the ICD-10-PCS tables in use at your facility. The code 08BL is a commonly reported prefix; confirm the full 7-character code against your coding team’s tables.

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📝 Coding Scenarios and Examples

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Scenario 1 — [SETTING: ASC / Outpatient Hospital]: ILM Peel for Full-Thickness Macular Hole (Right Eye)

Clinical Vignette: A 68-year-old female presents with a 6-month history of progressive central vision loss in her right eye. OCT confirms a full-thickness macular hole, stage II, measuring 400 µm in the right eye. Best-corrected visual acuity is 20/80 OD. Pars plana vitrectomy with ILM peel and C₃F₈ gas tamponade is performed through 25-gauge trocars. The ILM is stained with brilliant blue and peeled in a circumferential fashion with intraocular forceps over the macular hole. Fluid-air exchange is performed, followed by C₃F₈ gas injection. Postoperative face-down positioning is recommended. No concurrent cataract surgery is performed.

Field	Code	Rationale
CPT	67042--RT	Vitrectomy with ILM peel and gas tamponade, right eye
PDx	H35.341	Full-thickness macular hole, stage II or less, right eye — primary surgical indication

Note

No E/M code is billed — this is a surgical-only encounter. The global period is 000 (same day). A separate E/M service on the same date would require modifier -25 with adequate documentation, but routine pre- and postoperative assessments are not separately billable on a 000 global code.

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Scenario 2 — [SETTING: ASC]: ILM Peel for Diabetic Macular Edema (Left Eye)

Clinical Vignette: A 55-year-old male with type 2 diabetes, status post 4 intravitreal anti-VEGF injections in the left eye with persistent center-involving DME on OCT, presents for surgical management. Pars plana vitrectomy with ILM peel and SF₆ gas tamponade is performed on the left eye through 25-gauge trocars. The ILM is stained with ICG and peeled. The patient has no cataract in the right eye; the right eye is not addressed.

Field	Code	Rationale
CPT	67042--LT	Vitrectomy with ILM peel and gas tamponade, left eye
PDx	E11.322	Type 2 diabetes mellitus with diabetic macular edema, left eye
SDx	E11.9	Type 2 diabetes mellitus without complications — supports overall diabetes management

Note

DME refractory to anti-VEGF is an accepted surgical indication for ILM peel. The operative note should document failure of medical therapy (anti-VEGF injections) and the rationale for surgical intervention.

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Scenario 3 — [SETTING: ASC]: ILM Peel for Recurrent Macular Hole (Left Eye)

Clinical Vignette: A 72-year-old female had a prior pars plana vitrectomy with ILM peel for a left-eye macular hole 18 months ago. She now reports recurrent central vision loss. OCT confirms a recurrent full-thickness macular hole with reopened edges. A revision PPV with repeat ILM peel and C₃F₈ gas tamponade is performed.

Field	Code	Rationale
CPT	67042--LT	Repeat vitrectomy with ILM peel, left eye — same code as primary procedure
PDx	H35.342	Full-thickness macular hole, recurrent, left eye
SDx	H35.342	Used as both PDx and SDx when no additional diagnoses are documented

Note

There is no time limitation on reporting a repeat vitrectomy for recurrent macular hole. The 000 global period for 67042 means no global period restrictions exist. The subsequent procedure is coded identically to the primary.

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⚠️ Common Coding Pitfalls

	Pitfall or Tip
❌	Confusing 67042 with 67041 (ERM vs. ILM). The single most common coding error in vitrectomy coding. 67041 targets the preretinal cellular membrane (epiretinal membrane/macular pucker); 67042 targets the internal limiting membrane. These are anatomically distinct membranes. If the operative note states “membrane peel” without specifying which membrane, query the surgeon. Submitting 67041 when an ILM peel was performed understates the procedure.
❌	Bundling 67042 with 67039 on the same eye/session. These codes are NCCI-bundled (indicator 1). When ILM peel AND focal endolaser are both performed on the same eye in the same session, report only 67042 (higher RVU). Do NOT append modifier -59 to force payment of both — only one code is payable.
❌	Omitting tamponade from documentation but billing 67042. Although tamponade is “included if performed” per the code descriptor, the operative note should still document whether air, gas, or silicone oil was injected. This language protects the code selection if audited, even when tamponade is not ultimately used.
❌	Failing to append laterality modifiers. 67042 requires -RT or -LT to specify which eye was treated. Claims without laterality modifiers will be denied or delayed by most payers. Unspecified laterality is not acceptable for unilateral procedures.
❌	Reporting 67121 (silicone oil removal) with 67042. CPT 67121 is NCCI-bundled with the entire vitrectomy family (67036-67043). When silicone oil is placed during the index vitrectomy and removed in a subsequent session, report only the vitrectomy code (either the original code or 67042 if ILM peel is also performed) — NOT 67121.
✅	Document membrane staining technique. Always document the vital dye used (ICG, brilliant blue G, triamcinolone) and the technique of ILM peeling (continuous curvilinear, temporal-first, etc.). This supports the distinction between 67041 and 67042 on audit and justifies the higher-RVU code selection.
✅	Capture all documented diagnoses. When vitrectomy with ILM peel is performed for DME, code both the DME (e.g., E11.321) and the macular hole if present (e.g., H35.341). Capturing all documented conditions ensures accurate HCC risk adjustment and RAF scoring for Medicare Advantage plans.
✅	Verify assistant surgeon rules. Assistant surgeon billing for vitrectomy is payer-specific and often not covered. Do not report assistant surgeon codes (-80) unless the operative note documents a distinct assistant surgeon role AND the payer’s policy permits it.

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📚 Sources

¹ American Medical Association. CPT Professional Edition 2026. American Medical Association. Section 11: “Surgery on the Eye and Ocular Adnexa — Posterior Segment,” codes 67036-67043. ² CMS. “Medicare Physician Fee Schedule — CY 2026 Final Rule (CMS-1832-F).” Addendum B: Relative Value Units. Work RVU for CPT 67042: ~20.48 (verify against 2026 tables; subject to -2.5% efficiency adjustment per ASCRS alert if not exempted as time-based). Conversion factor: ~$33.40. CMS Physician Fee Schedule Look-Up Tool, accessed May 2026. ³ CMS. “Medicare National Correct Coding Initiative (NCCI) Policy Manual, 2026 Release.” Chapter 4 — Correct Coding. CPT codes 67036-67043 are mutually bundled per NCCI procedure-to-procedure edits when performed on the same eye/same session. Indicator varies by code pair. ⁴ Retina Today / Boyd K. P. Kalehoff, COA. “Properly Coding Retina Surgeries.” Retina Today, July/August 2019. — Code selection algorithm for PPV with ILM peel vs. ERM peel vs. endolaser; NCCI bundling guidance. ⁵ ASRS Coding Committee / Sharon Fekrat, MD, and Kimberly D. Woodke. “Retina Coding Update.” ASRS Business of Retina, 2024. — Detailed vitrectomy code family comparison, co-surgeon modifier guidance, and NCCI workflow steps for vitrectomy billing. ⁶ American Academy of Ophthalmology. “Unbundling: National Correct Coding Initiative (NCCI) Edits.” EyeNet Magazine, AAO. — Explanation of PTP edit indicators (0/1), modifier -59 unbundling rules, and ophthalmology-specific examples. ⁷ CMS. “IPPS Final Rule FY2026 — Inpatient Prospective Payment System.” MS-DRG Definitions Manual v43. — Not directly applicable (outpatient-only procedure) but referenced for completeness if vitrectomy occurs during inpatient admission. ⁸ FastRVU. “2026 CMS Physician Fee Schedule Data — Ophthalmology RVU Lookup.” fastrvu.com/resources/cms-2026-data. — RVU and Medicare rate reference for ophthalmology CPT codes including 67042.