CPT code 68040: Eyelid lesion treatment, without incision, excluding chalazion2026 Medicare rate & RVUs in Aromas, California

CPT 68040: $67.24–$78.69 office ($41.69–$46.90 facility) across 2 localities in Aromas, CA in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

Medicare pays $67.24–$78.69 for 68040 in the office in Aromas, California, from Salinas, CA to San Benito County, CA. Which amount applies depends on the service address.

$67.24–$78.69Office (non-facility)
$41.69–$46.90Hospital or facility

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 68040 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Aromas, California
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 68040 pays more and less in Aromas, California

Aromas, California maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

68040 office and facility rates by payment locality
Payment localityOfficeFacility
Salinas, CA$67.24$41.69
San Benito County, CA$78.69$46.90

How payment areas work in Aromas

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Monterey · Monterey County
  • San Benito · San Benito County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 68040 rate is calculated

Each of 68040’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 · 68040

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.83

0.83 RVUs× 1.000 GPCI

Practice expense0.98

0.98 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

1.8500

Conversion factor

$33.4009

Medicare rate

$61.79

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 68040

The CMS indicators that decide how 68040 is paid alongside other services.

CMS payment indicators · 68040

Eyelid lesion treatment, without incision, excluding chalazion

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68040 without 50 · national office

$61.79

Eyelid lesion treatment, without incision, excluding chalazion

68040-50 · Bilateral: 150%

$92.69

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

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 68040PPRRVU2026_Oct_nonQPP.csv, line 7,534 (RVU26D)

Open CMS sourceHow we calculate rates

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