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CPT code 68020: Conjunctival cyst drainage, incision and drainage2026 Medicare rate & RVUs in Washington, DC area

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.

CMS RVU26DEffective Oct 1, 2026One payment locality2.5K Medicare services in 2024

In Washington, DC area, Medicare pays $136.92 for 68020 in the office and $105.83 when it’s performed in a hospital or facility.

$136.92Office (non-facility)
$105.83Hospital or facility
+12.9%vs the national office rate ($121.25)

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.

We’ll open 68020 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 68020 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Washington, DC area 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. Washington, DC area pays $136.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

68020 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$136.92
  2. Los Angeles, CA · California$135.33−$1.59
  3. Miami, FL · Florida$128.80−$8.12
  4. Chicago, IL · Illinois$125.82−$11.10
  5. Manhattan, NY · New York$137.64+$0.72
  6. Alaska · Alaska$147.63+$10.71
  7. Alabama · Alabama$110.92−$26.00

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

68020 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$109.61$86.95
ArizonaArizona$118.58$93.01
Bakersfield, CACalifornia$127.87$98.95
Chico, CACalifornia$127.56$98.64
El Centro, CACalifornia$127.58$98.66
Fresno, CACalifornia$127.56$98.64
Hanford, CACalifornia$127.56$98.64
Madera, CACalifornia$127.56$98.64

68020 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
68020 office rate range by state
State / territoryOffice rate rangeLocalities
AK$147.631
AL$110.921
AR$109.611
AZ$118.581
CA$127.56–$156.8129
CO$125.761
CT$128.351
DC$136.921
DE$120.311
FL$119.58–$128.803
GA$114.03–$123.142
GU$129.861
HI$129.861
IA$113.301
ID$113.891
IL$116.66–$125.844
IN$114.431
KS$112.831
KY$112.981
LA$112.82–$117.402
MA$125.20–$136.802
MD$122.33–$136.923
ME$114.34–$119.492
MI$115.36–$120.782
MN$121.221
MO$111.21–$117.793
MS$110.431
MT$121.241
NC$115.331
ND$119.461
NE$113.821
NH$123.831
NJ$130.02–$135.902
NM$115.861
NV$120.821
NY$116.75–$140.415
OH$114.991
OK$112.861
OR$120.06–$129.222
PA$115.16–$125.612
PR$121.991
RI$124.181
SC$115.311
SD$119.251
TN$113.291
TX$114.54–$125.188
UT$116.611
VA$119.13–$136.922
VI$121.991
VT$119.041
WA$124.95–$139.382
WI$116.131
WV$113.091
WY$120.461

See 68020 in every payment locality

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

Office or facility?

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 68020 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.38× 1.0541.4545
Practice expense2.16× 1.1782.5445
Malpractice0.09× 1.1130.1002
Total RVUs4.0992
Conversion factor× 33.4009

Office rate, Washington, DC area$136.92

Office: (1.38 × 1.054 + 2.16 × 1.178 + 0.09 × 1.113) × $33.4009 = $136.92

Facility: (1.38 × 1.054 + 1.37 × 1.178 + 0.09 × 1.113) × $33.4009 = $105.83

Open 68020 in the RVU calculator

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

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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).

When to use modifier 50

Codes related to 68020

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 68020
CodeHow it relatesOffice range, Washington, DC area
Used instead
68100Conjunctival biopsy, diagnostic tissue samplingConjunctival biopsy when tissue sampling, rather than cyst drainage, is performed.$205.98
68110Conjunctival excision, lesion under 1 cmConjunctival lesion excision for lesions up to 1 cm, rather than drainage.$272.12
68115Conjunctival excision, lesion larger than 1 cmConjunctival lesion excision for lesions over 1 cm, rather than drainage.$379.78

How 68020 has changed in Washington, DC area

68020 · Office / nonfacility

$136.92

Effective 2026-10-01

The base rate is $3.62 higher than on 2025-10-01, moving from $133.30 to $136.92 (2.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $133.30changed to$136.92

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $137.57changed to$133.30

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.11 changed to 2.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $135.33changed to$137.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $140.56changed to$135.33

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.08 changed to 2.11
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $142.67changed to$140.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.02 changed to 2.08
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $143.43changed to$142.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.01 changed to 2.02

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $141.63changed to$143.43

    • 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 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $141.40changed to$141.63

    • 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 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $141.25changed to$141.40

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $138.41changed to$141.25

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.86 changed to 1.92
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $138.27changed to$138.41

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $138.77changed to$138.27

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $138.07changed to$138.77

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $141.27changed to$138.07

    • 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 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $141.11changed to$141.27

    • 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 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $141.11

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$136.92$105.83RVU26D
2026-07-01$136.92$105.83RVU26C
2026-04-01$136.92$105.83RVU26B
2026-01-01$136.92$105.83RVU26A
2025-10-01$133.30$120.19RVU25D
2025-07-01$133.30$120.19RVU25C
2025-04-01$133.30$120.19RVU25B
2025-01-01$133.30$120.19RVU25A
2024-10-01$137.57$123.69RVU24D
2024-07-01$137.57$123.69RVU24C
2024-04-01$137.57$123.69RVU24B
2024-03-09$137.57$123.69RVU24AR
2024-01-01$135.33$121.67RVU24A
2023-10-01$140.56$126.16RVU23D
2023-07-01$140.56$126.16RVU23C
2023-04-01$140.56$126.16RVU23B
2023-01-01$140.56$126.16RVU23A
2022-10-01$142.67$128.13RVU22D
2022-07-01$142.67$128.13RVU22C
2022-04-01$142.67$128.13RVU22B
2022-01-01$142.67$128.13RVU22A
2021-10-01$143.43$129.19RVU21D
2021-07-01$143.43$129.19RVU21C
2021-04-01$143.43$129.19RVU21B
2021-01-01$143.43$129.19RVU21A
2020-10-01$141.63$128.41RVU20D
2020-07-01$141.63$128.41RVU20C
2020-04-01$141.63$128.41RVU20B
2020-01-01$141.63$128.41RVU20A
2019-10-01$141.40$128.81RVU19D
2019-07-01$141.40$128.81RVU19C
2019-04-01$141.40$128.81RVU19B
2019-01-01$141.40$128.81RVU19A
2018-10-01$141.25$128.67RVU18D
2018-07-01$141.25$128.67RVU18C
2018-04-01$141.25$128.67RVU18B
2018-01-01$141.25$128.67RVU18AR1
2017-10-01$138.41$127.60RVU17D
2017-07-01$138.41$127.60RVU17C
2017-04-01$138.41$127.60RVU17B
2017-01-01$138.41$127.60RVU17A
2016-10-01$138.27$127.48RVU16D
2016-07-01$138.27$127.48RVU16C
2016-04-01$138.27$127.48RVU16B
2016-01-01$138.27$127.48RVU16A
2015-10-01$138.77$127.94RVU15D
2015-07-01$138.77$127.94RVU15C
2015-04-01$138.07$127.30RVU15B
2015-01-01$138.07$127.30RVU15A
2014-10-01$141.27$131.37RVU14D
2014-07-01$141.27$131.37RVU14C
2014-04-01$141.27$131.37RVU14B
2014-01-01$141.27$131.37RVU14A
2013-10-01$141.11$130.11RVU13D
2013-07-01$141.11$130.11RVU13C
2013-04-01$141.11$130.11RVU13B
2013-01-01$141.11$130.11RVU13AR

Price 68020 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 68020PPRRVU2026_Oct_nonQPP.csv, line 7,533 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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