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

Reports nonincisional treatment of an eyelid lesion, such as molluscum contagiosum, when the lesion is treated rather than biopsied or excised.

CMS RVU26DEffective Oct 1, 2026One payment locality2.9K Medicare services in 2024

In Connecticut, Medicare pays $65.15 for 68040 in the office and $41.41 when it’s performed in a hospital or facility.

$65.15Office (non-facility)
$41.41Hospital or facility
+5.4%vs the national office rate ($61.79)

Check a contract rate as a % of Medicare · 68040 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 68040 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 68040 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 68040 covers

This service covers treatment of a non-chalazion lesion on the eyelid without making an incision. A typical example is treating eyelid molluscum contagiosum. Ophthalmologists and other clinicians who provide eye care may perform it in an office or outpatient setting. The procedure is directed at a clinically identified lesion; it is distinct from taking a biopsy to establish a diagnosis or surgically excising a lesion.

Choose the code when the documented service treats an eyelid lesion without incision, and distinguish it from chalazion treatment and procedures requiring incision or excision. Record the lesion’s eyelid location, clinical nature, and treatment performed. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 Connecticut compares for 68040

Across 109 of 109 payment localities, the office rate for 68040 runs from $56.53 in Arkansas to $78.69 in San Benito County, CA. Connecticut pays $65.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

68040 in Connecticut vs other payment areas
  1. Connecticut · this page$65.15
  2. Los Angeles, CA · California$68.47+$3.32
  3. Washington, DC area · District of Columbia$69.27+$4.12
  4. Miami, FL · Florida$65.18+$0.03
  5. Chicago, IL · Illinois$63.88−$1.27
  6. Manhattan, NY · New York$69.65+$4.50
  7. Alaska · Alaska$77.18+$12.03

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

68040 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$57.12$37.83
ArkansasArkansas$56.53$37.59
ArizonaArizona$60.58$39.22
Bakersfield, CACalifornia$64.94$40.78
Chico, CACalifornia$64.79$40.62
El Centro, CACalifornia$64.79$40.63
Fresno, CACalifornia$64.79$40.62
Hanford, CACalifornia$64.79$40.62

68040 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.

$56.53

$77.18

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
68040 office rate range by state
State / territoryOffice rate rangeLocalities
AK$77.181
AL$57.121
AR$56.531
AZ$60.581
CA$64.79–$78.6929
CO$63.931
CT$65.151
DC$69.271
DE$61.401
FL$61.02–$65.183
GA$58.51–$62.672
GU$65.711
HI$65.711
IA$58.201
ID$58.471
IL$59.70–$63.904
IN$58.721
KS$57.991
KY$58.041
LA$57.97–$60.042
MA$63.70–$69.132
MD$62.35–$69.273
ME$58.67–$61.002
MI$59.12–$61.562
MN$61.801
MO$57.24–$60.223
MS$56.891
MT$61.791
NC$59.121
ND$61.001
NE$58.441
NH$62.971
NJ$66.04–$68.872
NM$59.341
NV$61.601
NY$59.76–$70.905
OH$58.951
OK$57.991
OR$61.26–$65.532
PA$59.03–$63.892
PR$62.131
RI$63.251
SC$59.101
SD$60.901
TN$58.191
TX$58.75–$63.598
UT$59.691
VA$60.84–$69.272
VI$62.131
VT$60.801
WA$63.57–$70.362
WI$59.491
WV$58.081
WY$61.441

See 68040 in every payment locality

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.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,534

Code
68040
Physician work
0.83
Practice expense
0.98
Malpractice
0.04

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 68040 in Connecticut
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0200.8466
Practice expense0.98× 1.0771.0555
Malpractice0.04× 1.2100.0484
Total RVUs1.9505
Conversion factor× 33.4009

Office rate, Connecticut$65.15

Office: (0.83 × 1.02 + 0.98 × 1.077 + 0.04 × 1.21) × $33.4009 = $65.15

Facility: (0.83 × 1.02 + 0.32 × 1.077 + 0.04 × 1.21) × $33.4009 = $41.41

Open 68040 in the RVU calculator

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

Codes related to 68040

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

Codes related to 68040
CodeHow it relatesOffice range, Connecticut
Used instead
67800Chalazion removal, single lesionFor chalazion treatment, rather than treatment of a non-chalazion eyelid lesion.$138.53
67810Eyelid biopsy, eyelid skin or marginBiopsy is the relevant service when eyelid tissue is sampled for diagnosis.$193.27
67840Eyelid lesion excision, excludes chalazionFor surgical excision of an eyelid lesion instead of nonincisional treatment.$296.16
68020Conjunctival cyst drainage, incision and drainageTreats a conjunctival cyst by incision and drainage, at a different anatomic site.$128.35

How 68040 has changed in Connecticut

68040 · Office / nonfacility

$65.15

Effective 2026-10-01

The base rate is $0.90 higher than on 2025-10-01, moving from $64.25 to $65.15 (1.4%).

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

    $64.25changed to$65.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.85 changed to 0.83
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $65.75changed to$64.25

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.97 changed to 0.98

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $64.68changed to$65.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $66.22changed to$64.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.94 changed to 0.97
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $67.26changed to$66.22

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.92 changed to 0.94
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $67.43changed to$67.26

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.91 changed to 0.92

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $68.89changed to$67.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.88 changed to 0.91
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $68.80changed to$68.89

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $68.73changed to$68.80

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $67.51changed to$68.73

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.85 changed to 0.88
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $68.29changed to$67.51

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.87 changed to 0.85
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $68.13changed to$68.29

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.86 changed to 0.87

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $67.79changed to$68.13

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $74.19changed to$67.79

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.91 changed to 0.86
    • Malpractice RVU 0.15 changed to 0.05
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $73.72changed to$74.19

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.99 changed to 0.91
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $73.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$65.15$41.41RVU26D
2026-07-01$65.15$41.41RVU26C
2026-04-01$65.15$41.41RVU26B
2026-01-01$65.15$41.41RVU26A
2025-10-01$64.25$48.72RVU25D
2025-07-01$64.25$48.72RVU25C
2025-04-01$64.25$48.72RVU25B
2025-01-01$64.25$48.72RVU25A
2024-10-01$65.75$49.41RVU24D
2024-07-01$65.75$49.41RVU24C
2024-04-01$65.75$49.41RVU24B
2024-03-09$65.75$49.41RVU24AR
2024-01-01$64.68$48.60RVU24A
2023-10-01$66.22$49.79RVU23D
2023-07-01$66.22$49.79RVU23C
2023-04-01$66.22$49.79RVU23B
2023-01-01$66.22$49.79RVU23A
2022-10-01$67.26$50.69RVU22D
2022-07-01$67.26$50.69RVU22C
2022-04-01$67.26$50.69RVU22B
2022-01-01$67.26$50.69RVU22A
2021-10-01$67.43$51.11RVU21D
2021-07-01$67.43$51.11RVU21C
2021-04-01$67.43$51.11RVU21B
2021-01-01$67.43$51.11RVU21A
2020-10-01$68.89$53.62RVU20D
2020-07-01$68.89$53.62RVU20C
2020-04-01$68.89$53.62RVU20B
2020-01-01$68.89$53.62RVU20A
2019-10-01$68.80$53.98RVU19D
2019-07-01$68.80$53.98RVU19C
2019-04-01$68.80$53.98RVU19B
2019-01-01$68.80$53.98RVU19A
2018-10-01$68.73$54.32RVU18D
2018-07-01$68.73$54.32RVU18C
2018-04-01$68.73$54.32RVU18B
2018-01-01$68.73$54.32RVU18AR1
2017-10-01$67.51$54.69RVU17D
2017-07-01$67.51$54.69RVU17C
2017-04-01$67.51$54.69RVU17B
2017-01-01$67.51$54.69RVU17A
2016-10-01$68.29$55.04RVU16D
2016-07-01$68.29$55.04RVU16C
2016-04-01$68.29$55.04RVU16B
2016-01-01$68.29$55.04RVU16A
2015-10-01$68.13$55.24RVU15D
2015-07-01$68.13$55.24RVU15C
2015-04-01$67.79$54.97RVU15B
2015-01-01$67.79$54.97RVU15A
2014-10-01$74.19$61.00RVU14D
2014-07-01$74.19$61.00RVU14C
2014-04-01$74.19$61.00RVU14B
2014-01-01$74.19$61.00RVU14A
2013-10-01$73.72$60.13RVU13D
2013-07-01$73.72$60.13RVU13C
2013-04-01$73.72$60.13RVU13B
2013-01-01$73.72$60.13RVU13AR

Price 68040 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Connecticut

68040 billing questions

When should this code be chosen instead of an eyelid excision code?

Use it for treatment of an eyelid lesion without incision. If the clinician surgically removes the lesion, consider the excision code that matches the service instead.

Can this code be used for a chalazion?

No. Chalazion is excluded from this lesion-treatment service; use the chalazion-specific code when that is the condition treated.

What documentation supports reporting it?

Document the lesion’s location and clinical nature, that it was on the eyelid and was not a chalazion, and the nonincisional treatment performed.

How is bilateral treatment reported?

CMS pricing recognizes bilateral reporting with modifier 50 at 150%. Document treatment on both sides.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. CMS applies the multiple-procedure reduction when other procedures are performed in the same session.

Is an assistant or co-surgeon payable for this service?

Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted under the CMS rules for this code.

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)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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