Price AtlasInteractive atlas · All states · techysurgeon.comWhat the whole vitrectomy (retina surgery) costs
Removing the eye's gel (67036); with membrane peeling for macular hole or pucker (67042/67041). Every bill that usually comes with it, who sends it, and where each number comes from.
Price it for your ZIP, hospital or insurerRates by insurer
Medicare, national amounts, 2026
| Bill | Surgery center | Hospital outpatient |
|---|---|---|
| Facility | $2,204 | $4,223 |
| Surgeon | $759 | $759 |
| Assistant | $121 | $121 |
| Anesthesia | $219 | $219 |
| Before surgery (typical) | $177 | $177 |
| Total | $3,481 | $5,500 |
National Medicare amounts (payment-area and wage adjustments at 1.0). Facility: OPPS Addendum B, July 2026 (national unadjusted rate); local = rate × (0.6 × wage index + 0.4); ASC Addendum AA, July 2026 (national rate); local = rate × (0.5 × wage index + 0.5); device-intensive (J8) codes keep the device portion unadjusted; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons. Surgeon: CMS Physician Fee Schedule CY2026 (RVU26D). Anesthesia: CMS base units × the CY2026 anesthesia conversion factor, with an assumed case time. An educational estimate, not a quote.
Line by line (surgery center)
- Surgery center facility fee: $2,204. Billed by The surgery center. CMS ASC Addendum AA, July 2026: national rate $2,203.87
- Surgeon, CPT 67036: $759. Billed by The surgeon's group. CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026 release), facility rate, PFS locality national (GPCI 1.0)
- Assistant surgeon (modifier 80): $121. Billed by The assistant surgeon. Medicare Claims Processing Manual, Ch. 12, §20.4.3: assistant-at-surgery (modifiers 80/81/82) = 16% of the surgeon's fee schedule amount; a PA, NP or CNS assisting (modifier AS) = 85% of that, 13.6%. Indicator from the RVU26D ASST SURG column (0 = only with documented medical necessity, 1 = not paid, 2 = paid).
- Anesthesia, ASA code 00145: $219. Billed by The anesthesia group. CMS anesthesia base units (CY2022 file, unchanged for CY2026) + CY2026 anesthesia conversion factor $20.49754 for the nation (ANES2026, RVU26D). Code mapping is ours, from the ASA code descriptors.
- Consultation visit (new patient): $177. Billed by The surgeon's group. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 99204
Questions
How much does a vitrectomy (retina surgery) cost in total, with every bill?
At national Medicare rates for 2026, the whole vitrectomy (retina surgery) comes to about $3,481 in a surgery center and about $5,500 in a hospital outpatient, counting the facility, the surgeon, anesthesia and typical care before and after. Commercial plans usually pay more; local rates differ by area.
Why do I get separate bills for a vitrectomy (retina surgery)?
The surgery center bills for the facility; the surgeon's group bills for the operation (Surgeon, CPT 67036, about $759 from Medicare nationally); the anesthesia group bills by base units plus time (about $219 at our default time); labs, imaging, pathology and therapy each come from their own provider.
What does the surgeon's fee include?
90-day global: the fee covers the operation plus the visit the day before and routine follow-up visits for 90 days.