CPT 67025
Global 090 ActiveReplace eye fluid
CPT 67025 Billing & Documentation Guide
CPT code 67025 (Replace eye fluid) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 7.91, a non-facility practice expense RVU of 13.7, and a malpractice RVU of 0.62, a total non-facility RVU of 22.23 and facility RVU of 16.17. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $764.89, though rates vary from $667.94 to $964.21 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 67025, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 67025 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 67025 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 67025
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 7.91 | 7.91 |
| Practice Expense RVU | 13.7 | 7.64 |
| Malpractice RVU | 0.62 | 0.62 |
| Total RVU | 22.23 | 16.17 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 67025
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $826.35 | $586.85 | $781.31 - $964.21 | 29 |
| Florida | $763.63 | $560.55 | $732.78 - $792.93 | 3 |
| Georgia | $725.92 | $532.82 | $697.06 - $754.78 | 2 |
| Illinois | $746.85 | $551.27 | $714.35 - $773.46 | 4 |
| Michigan | $723.03 | $532.96 | $705.36 - $740.69 | 2 |
| North Carolina | $704.37 | $515.52 | $704.37 - $704.37 | 1 |
| New York | $815.37 | $589.56 | $713.47 - $863.64 | 5 |
| Ohio | $702.86 | $518.06 | $702.86 - $702.86 | 1 |
| Pennsylvania | $736.93 | $538.67 | $703.84 - $770.02 | 2 |
| Texas | $735.39 | $536.12 | $699.85 - $767.21 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 67025
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 67025 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0124T | Column 1 (primary), can be billed with modifier | Yes | Anesthesia service included in surgical procedure |
| 0186T | Column 1 (primary), can be billed with modifier | Yes | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0465T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 67025
What does CPT code 67025 mean? +
CPT code 67025 represents: Replace eye fluid. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 67025? +
The 2026 Medicare national average non-facility payment for CPT 67025 is $764.89. Rates range from $667.94 to $964.21 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 67025? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 67025? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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