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LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2025
2024
QW Tests

Physician Fee Schedule

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OPPS Fee Schedule

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ASC Fee Schedule

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APC Codes

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ASP Drug Pricing Files

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CMS Transmittals



.

National Coverage Determination
Procedure Code: 8XXXX
Vitrectomy
CMS Policy Number: 80.11
Back to NCD List



To review all requirements of this policy, please see: CMS NCD listing by Chapter

Covered ICD-10 Codes.

E08.3511Diab with prolif diabetic rtnop with macular edema, r eye
E08.3512Diab with prolif diabetic rtnop with macular edema, left eye
E08.3513Diabetes with prolif diabetic rtnop with macular edema, bi
E08.3521Diab with prolif diab rtnop with trctn dtch macula, r eye
E08.3522Diab with prolif diab rtnop with trctn dtch macula, left eye
E08.3523Diab with prolif diabetic rtnop with trctn dtch macula, bi
E08.3531Diab with prolif diab rtnop with trctn dtch n-mcla, r eye
E08.3532Diab with prolif diab rtnop with trctn dtch n-mcla, left eye
E08.3533Diab with prolif diabetic rtnop with trctn dtch n-mcla, bi
E08.3541Diabetes with prolif diabetic rtnop with comb detach, r eye
.... and many more.


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