CPT code 68020: Conjunctival cyst drainage, incision and drainage2026 Medicare rate & RVUs in Oxnard, CA
Report this service when an ophthalmologist opens and drains a cyst of the conjunctiva, rather than excising a conjunctival lesion or treating an eyelid lesion.
In Oxnard, CA, Medicare pays $134.53 for 68020 in the office and $103.34 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 68020 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 68020 covers
This service involves making an incision in a conjunctival cyst and draining its contents. Ophthalmologists typically perform it as a minor procedure in an office or facility setting, often after examining the eye and identifying the cyst on the conjunctival surface. The code is for a cyst of the conjunctiva, not an abscess in the eyelid or a chalazion treated by excision.
Report the service when the documented treatment is incision and drainage; documentation should identify the conjunctival cyst and the procedure performed. The CMS global period is 10 days, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Oxnard, CA compares for 68020
Across 109 of 109 payment localities, the office rate for 68020 runs from $109.61 in Arkansas to $156.81 in San Benito County, CA. Oxnard, CA pays $134.53. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Oxnard, CA · this page$134.53
- Bakersfield, CA · California$127.87−$6.66
- Chico, CA · California$127.56−$6.97
- El Centro, CA · California$127.58−$6.95
- Fresno, CA · California$127.56−$6.97
- Hanford, CA · California$127.56−$6.97
- Los Angeles, CA · California$135.33+$0.80
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $127.56 | $98.64 |
| Merced, CACalifornia | $127.56 | $98.64 |
| Modesto, CACalifornia | $127.56 | $98.64 |
| Napa, CACalifornia | $145.61 | $110.83 |
| Redding, CACalifornia | $127.56 | $98.64 |
| Rest of CaliforniaCalifornia | $127.56 | $98.64 |
| Riverside, CACalifornia | $128.56 | $99.64 |
| Sacramento, CACalifornia | $133.27 | $102.58 |
| Salinas, CACalifornia | $132.75 | $102.17 |
| San Diego, CACalifornia | $135.39 | $103.83 |
| Marin County, CACalifornia | $153.58 | $116.37 |
| San Francisco, CACalifornia | $153.48 | $116.27 |
| San Benito County, CACalifornia | $156.81 | $118.76 |
| Santa Clara County, CACalifornia | $156.39 | $118.34 |
| San Luis Obispo, CACalifornia | $130.66 | $100.61 |
| Santa Cruz, CACalifornia | $136.33 | $104.27 |
| Santa Maria, CACalifornia | $133.12 | $102.35 |
| Santa Rosa, CACalifornia | $137.68 | $105.28 |
| Stockton, CACalifornia | $127.56 | $98.64 |
| Vallejo, CACalifornia | $145.47 | $110.69 |
| Visalia, CACalifornia | $127.56 | $98.64 |
| Yuba City, CACalifornia | $127.56 | $98.64 |
| Washington, DC areaDistrict of Columbia | $136.92 | $105.83 |
| Miami, FLFlorida | $128.80 | $101.33 |
| Chicago, ILIllinois | $125.82 | $99.30 |
| Manhattan, NYNew York | $137.64 | $106.98 |
| AlaskaAlaska | $147.63 | $119.53 |
| AlabamaAlabama | $110.92 | $87.83 |
| ArkansasArkansas | $109.61 | $86.95 |
| ArizonaArizona | $118.58 | $93.01 |
| ColoradoColorado | $125.76 | $97.68 |
| ConnecticutConnecticut | $128.35 | $99.94 |
| DelawareDelaware | $120.31 | $94.24 |
| Fort Lauderdale, FLFlorida | $124.61 | $97.88 |
| Rest of FloridaFlorida | $119.58 | $94.36 |
| Atlanta, GAGeorgia | $123.14 | $96.33 |
| Rest of GeorgiaGeorgia | $114.03 | $90.49 |
| Hawaii, Guam, HIHawaii | $129.86 | $99.86 |
| IowaIowa | $113.30 | $89.16 |
| IdahoIdaho | $113.89 | $89.61 |
| East St. Louis, ILIllinois | $118.52 | $94.25 |
| Rest of IllinoisIllinois | $116.66 | $92.57 |
| Suburban Chicago, ILIllinois | $125.84 | $98.74 |
| IndianaIndiana | $114.43 | $89.97 |
| KansasKansas | $112.83 | $88.97 |
| KentuckyKentucky | $112.98 | $89.52 |
| New Orleans, LALouisiana | $117.40 | $92.57 |
| Rest of LouisianaLouisiana | $112.82 | $89.47 |
| Metropolitan Boston, MAMassachusetts | $136.80 | $105.30 |
| Rest of MassachusettsMassachusetts | $125.20 | $97.41 |
| Baltimore area, MDMaryland | $127.96 | $99.65 |
| Rest of MarylandMaryland | $122.33 | $95.62 |
| Rest of MaineMaine | $114.34 | $90.06 |
| Southern Maine, MEMaine | $119.49 | $93.34 |
| Detroit, MIMichigan | $120.78 | $95.32 |
| Rest of MichiganMichigan | $115.36 | $91.27 |
| MinnesotaMinnesota | $121.22 | $94.07 |
| Metropolitan Kansas City, MOMissouri | $116.78 | $92.00 |
| Metropolitan St. Louis, MOMissouri | $117.79 | $92.67 |
| Rest of MissouriMissouri | $111.21 | $88.47 |
| MississippiMississippi | $110.43 | $87.71 |
| MontanaMontana | $121.24 | $94.85 |
| North CarolinaNorth Carolina | $115.33 | $90.71 |
| North DakotaNorth Dakota | $119.46 | $93.07 |
| NebraskaNebraska | $113.82 | $89.47 |
| New HampshireNew Hampshire | $123.83 | $96.36 |
| Northern New JerseyNew Jersey | $135.90 | $105.29 |
| Rest of New JerseyNew Jersey | $130.02 | $101.20 |
| New MexicoNew Mexico | $115.86 | $91.66 |
| NevadaNevada | $120.82 | $94.40 |
| NYC suburbs and Long Island, NYNew York | $140.41 | $109.03 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $130.80 | $101.91 |
| Queens, NYNew York | $138.65 | $107.47 |
| Rest of New YorkNew York | $116.75 | $91.68 |
| OhioOhio | $114.99 | $90.90 |
| OklahomaOklahoma | $112.86 | $89.29 |
| Portland, OROregon | $129.22 | $99.91 |
| Rest of OregonOregon | $120.06 | $93.78 |
| Metropolitan Philadelphia, PAPennsylvania | $125.61 | $98.14 |
| Rest of PennsylvaniaPennsylvania | $115.16 | $90.94 |
| Puerto RicoPuerto Rico | $121.99 | $95.32 |
| Rhode IslandRhode Island | $124.18 | $96.92 |
| South CarolinaSouth Carolina | $115.31 | $90.93 |
| South DakotaSouth Dakota | $119.25 | $92.86 |
| TennesseeTennessee | $113.29 | $89.30 |
| Austin, TXTexas | $125.18 | $97.26 |
| Beaumont, TXTexas | $114.54 | $90.53 |
| Brazoria, TXTexas | $120.30 | $94.15 |
| Dallas, TXTexas | $120.94 | $94.66 |
| Fort Worth, TXTexas | $120.26 | $94.24 |
| Galveston, TXTexas | $120.59 | $94.39 |
| Houston, TXTexas | $122.24 | $96.04 |
| Rest of TexasTexas | $117.27 | $92.23 |
| UtahUtah | $116.61 | $91.81 |
| VirginiaVirginia | $119.13 | $93.20 |
| Virgin Islands, VIUnited States Virgin Islands | $121.99 | $95.32 |
| VermontVermont | $119.04 | $92.92 |
| Rest of WashingtonWashington | $124.95 | $97.16 |
| King County, WAWashington | $139.38 | $107.00 |
| WisconsinWisconsin | $116.13 | $90.86 |
| West VirginiaWest Virginia | $113.09 | $90.16 |
| WyomingWyoming | $120.46 | $94.08 |
68020 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$109.61
$147.63
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $147.63 | 1 |
| AL | $110.92 | 1 |
| AR | $109.61 | 1 |
| AZ | $118.58 | 1 |
| CA | $127.56–$156.81 | 29 |
| CO | $125.76 | 1 |
| CT | $128.35 | 1 |
| DC | $136.92 | 1 |
| DE | $120.31 | 1 |
| FL | $119.58–$128.80 | 3 |
| GA | $114.03–$123.14 | 2 |
| GU | $129.86 | 1 |
| HI | $129.86 | 1 |
| IA | $113.30 | 1 |
| ID | $113.89 | 1 |
| IL | $116.66–$125.84 | 4 |
| IN | $114.43 | 1 |
| KS | $112.83 | 1 |
| KY | $112.98 | 1 |
| LA | $112.82–$117.40 | 2 |
| MA | $125.20–$136.80 | 2 |
| MD | $122.33–$136.92 | 3 |
| ME | $114.34–$119.49 | 2 |
| MI | $115.36–$120.78 | 2 |
| MN | $121.22 | 1 |
| MO | $111.21–$117.79 | 3 |
| MS | $110.43 | 1 |
| MT | $121.24 | 1 |
| NC | $115.33 | 1 |
| ND | $119.46 | 1 |
| NE | $113.82 | 1 |
| NH | $123.83 | 1 |
| NJ | $130.02–$135.90 | 2 |
| NM | $115.86 | 1 |
| NV | $120.82 | 1 |
| NY | $116.75–$140.41 | 5 |
| OH | $114.99 | 1 |
| OK | $112.86 | 1 |
| OR | $120.06–$129.22 | 2 |
| PA | $115.16–$125.61 | 2 |
| PR | $121.99 | 1 |
| RI | $124.18 | 1 |
| SC | $115.31 | 1 |
| SD | $119.25 | 1 |
| TN | $113.29 | 1 |
| TX | $114.54–$125.18 | 8 |
| UT | $116.61 | 1 |
| VA | $119.13–$136.92 | 2 |
| VI | $121.99 | 1 |
| VT | $119.04 | 1 |
| WA | $124.95–$139.38 | 2 |
| WI | $116.13 | 1 |
| WV | $113.09 | 1 |
| WY | $120.46 | 1 |
How the 68020 rate is calculated
Each of 68020’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 68020
RVUs × geographic indexes × conversion factor
Work1.38
1.38 RVUs× 1.000 GPCI
Practice expense2.16
2.16 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
3.6300
Conversion factor
$33.4009
Medicare rate
$121.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Oxnard, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,533
- Code
- 68020
- Physician work
- 1.38
- Practice expense
- 2.16
- Malpractice
- 0.09
GPCI2026.csv
18
- Locality
- Oxnard, CA
- Physician work
- 1.028
- Practice expense
- 1.182
- Malpractice
- 0.623
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.38 | × 1.028 | 1.4186 |
| Practice expense | 2.16 | × 1.182 | 2.5531 |
| Malpractice | 0.09 | × 0.623 | 0.0561 |
| Total RVUs | 4.0278 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Oxnard, CA$134.53
Office: (1.38 × 1.028 + 2.16 × 1.182 + 0.09 × 0.623) × $33.4009 = $134.53
Facility: (1.38 × 1.028 + 1.37 × 1.182 + 0.09 × 0.623) × $33.4009 = $103.34
Payment rules and modifiers for 68020
68020 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68020
Conjunctival cyst drainage, incision and drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68020
Conjunctival cyst drainage, incision and drainage
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68020 without 50 · national office
$121.25
Conjunctival cyst drainage, incision and drainage
68020-50 · Bilateral: 150%
$181.88
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 68020 has changed in Oxnard, CA
68020 · Office / nonfacility
$134.53
Effective 2026-10-01
The base rate is $4.94 higher than on 2025-10-01, moving from $129.59 to $134.53 (3.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$129.59changed to$134.53
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.42 changed to 1.38
- Practice expense RVU 2.10 changed to 2.16
- Malpractice RVU 0.10 changed to 0.09
- Work GPCI 1.026 changed to 1.028
- Practice expense GPCI 1.183 changed to 1.182
- Malpractice GPCI 0.651 changed to 0.623
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$133.75changed to$129.59
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.11 changed to 2.10
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$131.57changed to$133.75
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$135.00changed to$131.57
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.08 changed to 2.11
- Work GPCI 1.027 changed to 1.026
- Practice expense GPCI 1.181 changed to 1.183
- Malpractice GPCI 0.689 changed to 0.651
January 1, 2023
RVU23A
$135.40changed to$135.00
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.02 changed to 2.08
- Practice expense GPCI 1.179 changed to 1.181
- Malpractice GPCI 0.726 changed to 0.689
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$136.11changed to$135.40
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.01 changed to 2.02
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$135.63changed to$136.11
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.90 changed to 2.01
- Malpractice RVU 0.09 changed to 0.10
- Work GPCI 1.026 changed to 1.027
- Practice expense GPCI 1.178 changed to 1.179
- Malpractice GPCI 0.700 changed to 0.726
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$136.20changed to$135.63
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.92 changed to 1.90
- Malpractice RVU 0.10 changed to 0.09
- Work GPCI 1.024 changed to 1.026
- Practice expense GPCI 1.176 changed to 1.178
- Malpractice GPCI 0.673 changed to 0.700
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$136.05changed to$136.20
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$133.68changed to$136.05
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.86 changed to 1.92
- Work GPCI 1.027 changed to 1.024
- Practice expense GPCI 1.178 changed to 1.176
- Malpractice GPCI 0.754 changed to 0.673
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$133.94changed to$133.68
- Conversion factor 35.8043 changed to 35.8887
- Work GPCI 1.030 changed to 1.027
- Practice expense GPCI 1.180 changed to 1.178
- Malpractice GPCI 0.834 changed to 0.754
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$134.42changed to$133.94
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$133.75changed to$134.42
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$136.06changed to$133.75
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.85 changed to 1.86
- Malpractice RVU 0.19 changed to 0.10
- Work GPCI 1.032 changed to 1.030
- Practice expense GPCI 1.187 changed to 1.180
- Malpractice GPCI 0.720 changed to 0.834
Held through RVU15B.
January 1, 2014
RVU14A
$136.47changed to$136.06
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.03 changed to 1.85
- Malpractice RVU 0.20 changed to 0.19
- Work GPCI 1.034 changed to 1.032
- Practice expense GPCI 1.193 changed to 1.187
- Malpractice GPCI 0.605 changed to 0.720
Held through RVU14B, RVU14C, RVU14D.
October 1, 2013
RVU13D
No ratechanged to$136.47
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $134.53 | $103.34 | RVU26D |
| 2026-07-01 | $134.53 | $103.34 | RVU26C |
| 2026-04-01 | $134.53 | $103.34 | RVU26B |
| 2026-01-01 | $134.53 | $103.34 | RVU26A |
| 2025-10-01 | $129.59 | $116.58 | RVU25D |
| 2025-07-01 | $129.59 | $116.58 | RVU25C |
| 2025-04-01 | $129.59 | $116.58 | RVU25B |
| 2025-01-01 | $129.59 | $116.58 | RVU25A |
| 2024-10-01 | $133.75 | $119.97 | RVU24D |
| 2024-07-01 | $133.75 | $119.97 | RVU24C |
| 2024-04-01 | $133.75 | $119.97 | RVU24B |
| 2024-03-09 | $133.75 | $119.97 | RVU24AR |
| 2024-01-01 | $131.57 | $118.01 | RVU24A |
| 2023-10-01 | $135.00 | $120.99 | RVU23D |
| 2023-07-01 | $135.00 | $120.99 | RVU23C |
| 2023-04-01 | $135.00 | $120.99 | RVU23B |
| 2023-01-01 | $135.00 | $120.99 | RVU23A |
| 2022-10-01 | $135.40 | $121.53 | RVU22D |
| 2022-07-01 | $135.40 | $121.53 | RVU22C |
| 2022-04-01 | $135.40 | $121.53 | RVU22B |
| 2022-01-01 | $135.40 | $121.53 | RVU22A |
| 2021-10-01 | $136.11 | $122.53 | RVU21D |
| 2021-07-01 | $136.11 | $122.53 | RVU21C |
| 2021-04-01 | $136.11 | $122.53 | RVU21B |
| 2021-01-01 | $136.11 | $122.53 | RVU21A |
| 2020-10-01 | $135.63 | $122.87 | RVU20D |
| 2020-07-01 | $135.63 | $122.87 | RVU20C |
| 2020-04-01 | $135.63 | $122.87 | RVU20B |
| 2020-01-01 | $135.63 | $122.87 | RVU20A |
| 2019-10-01 | $136.20 | $123.91 | RVU19D |
| 2019-07-01 | $136.20 | $123.91 | RVU19C |
| 2019-04-01 | $136.20 | $123.91 | RVU19B |
| 2019-01-01 | $136.20 | $123.91 | RVU19A |
| 2018-10-01 | $136.05 | $123.78 | RVU18D |
| 2018-07-01 | $136.05 | $123.78 | RVU18C |
| 2018-04-01 | $136.05 | $123.78 | RVU18B |
| 2018-01-01 | $136.05 | $123.78 | RVU18AR1 |
| 2017-10-01 | $133.68 | $123.11 | RVU17D |
| 2017-07-01 | $133.68 | $123.11 | RVU17C |
| 2017-04-01 | $133.68 | $123.11 | RVU17B |
| 2017-01-01 | $133.68 | $123.11 | RVU17A |
| 2016-10-01 | $133.94 | $123.37 | RVU16D |
| 2016-07-01 | $133.94 | $123.37 | RVU16C |
| 2016-04-01 | $133.94 | $123.37 | RVU16B |
| 2016-01-01 | $133.94 | $123.37 | RVU16A |
| 2015-10-01 | $134.42 | $123.82 | RVU15D |
| 2015-07-01 | $134.42 | $123.82 | RVU15C |
| 2015-04-01 | $133.75 | $123.20 | RVU15B |
| 2015-01-01 | $133.75 | $123.20 | RVU15A |
| 2014-10-01 | $136.06 | $126.28 | RVU14D |
| 2014-07-01 | $136.06 | $126.28 | RVU14C |
| 2014-04-01 | $136.06 | $126.28 | RVU14B |
| 2014-01-01 | $136.06 | $126.28 | RVU14A |
| 2013-10-01 | $136.47 | $125.51 | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Oxnard, CA rate applies
Oxnard, CA is a Medicare payment area, not a city. Our Census mapping connects it to 26 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Oxnard
- Thousand Oaks
- Bell Canyon
- Camarillo
- Casa Conejo
- Channel Islands Beach
- El Rio
- Fillmore
68020 billing questions
When is this code used instead of an eyelid drainage code?
Use this code for incision and drainage of a cyst in the conjunctiva. A collection in the eyelid itself is a different anatomic service.
Is this the code for excising a conjunctival cyst?
No. This code describes opening and draining the cyst. When the service is excision of a conjunctival lesion, select the code that matches the excision and lesion size.
Are related postoperative visits separately reportable?
Related postoperative visits within the 10-day global period are included in the procedure.
How is bilateral treatment reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
How does payment work when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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