67042 Vit for macular hole
Also known as: macular hole repair, ILM peel, internal limiting membrane dissection, macular hole surgery
Vitrectomy with dissection and internal limiting membrane peeling for repair of full-thickness macular hole.
In Plain Language
surgery to repair hole in macula; removal of internal eye membrane over hole
Clinical Context
Treatment of full-thickness macular hole causing central vision loss; internal limiting membrane peeling improves hole closure rate and visual recovery.
RVU Breakdown
| Work RVU | 15.92 |
| Total RVU | 15.92 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 15.92, this code ranks in the 75th percentile among Surgery codes — 2.0x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 67042?
CPT 67042 (Vit for macular hole) is a Surgery code. Vitrectomy with dissection and internal limiting membrane peeling for repair of full-thickness macular hole.
What is the wRVU value for CPT 67042?
The work RVU for CPT 67042 is 15.92. This code is primarily used by Ophthalmology, Retina. It has a 90-day global period.
When is CPT 67042 used?
Treatment of full-thickness macular hole causing central vision loss; internal limiting membrane peeling improves hole closure rate and visual recovery.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.