CPT code 68020: Conjunctival cyst drainage, incision and drainage2026 Medicare rate & RVUs in Illinois
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.
Medicare pays $116.66–$125.84 for 68020 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 68020 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$116.66 to $125.84
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $125.82 | $99.30 |
| East St. Louis, IL | $118.52 | $94.25 |
| Rest of Illinois | $116.66 | $92.57 |
| Suburban Chicago, IL | $125.84 | $98.74 |
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.
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).
68020 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67700Eyelid abscess drainageAbscess of the eyelid
- This code is for a conjunctival cyst. Code 67700 addresses incision and drainage of an abscess in the eyelid.
- 68040Eyelid lesion treatmentWithout incision, excluding chalazion
- This code drains a conjunctival cyst; 68040 is treatment of eyelid lesions, such as molluscum contagiosum or milia.
- 68110Conjunctival excisionLesion under 1 cm
- Use this code for incision and drainage of a conjunctival cyst. Code 68110 describes excision of a conjunctival lesion up to 1 cm.
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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