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

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 Delaware, Medicare pays $61.40 for 68040 in the office and $39.62 when it’s performed in a hospital or facility.

$61.40Office (non-facility)
$39.62Hospital or facility
−0.6%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 Delaware
  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 Delaware 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. Delaware pays $61.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

68040 in Delaware vs other payment areas
  1. Delaware · this page$61.40
  2. Los Angeles, CA · California$68.47+$7.07
  3. Washington, DC area · District of Columbia$69.27+$7.87
  4. Miami, FL · Florida$65.18+$3.78
  5. Chicago, IL · Illinois$63.88+$2.48
  6. Manhattan, NY · New York$69.65+$8.25
  7. Alaska · Alaska$77.18+$15.78

Other areas in Delaware 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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 68040 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0050.8341
Practice expense0.98× 0.9880.9682
Malpractice0.04× 0.8990.0360
Total RVUs1.8383
Conversion factor× 33.4009

Office rate, Delaware$61.40

Office: (0.83 × 1.005 + 0.98 × 0.988 + 0.04 × 0.899) × $33.4009 = $61.40

Facility: (0.83 × 1.005 + 0.32 × 0.988 + 0.04 × 0.899) × $33.4009 = $39.62

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, Delaware
Used instead
67800Chalazion removal, single lesionFor chalazion treatment, rather than treatment of a non-chalazion eyelid lesion.$129.48
67810Eyelid biopsy, eyelid skin or marginBiopsy is the relevant service when eyelid tissue is sampled for diagnosis.$179.19
67840Eyelid lesion excision, excludes chalazionFor surgical excision of an eyelid lesion instead of nonincisional treatment.$275.21
68020Conjunctival cyst drainage, incision and drainageTreats a conjunctival cyst by incision and drainage, at a different anatomic site.$120.31

How 68040 has changed in Delaware

68040 · Office / nonfacility

$61.40

Effective 2026-10-01

The base rate is $0.98 higher than on 2025-10-01, moving from $60.42 to $61.40 (1.6%).

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

    $60.42changed to$61.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.85 changed to 0.83
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $61.84changed to$60.42

    • 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

    $60.83changed to$61.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $62.35changed to$60.83

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.94 changed to 0.97
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $63.38changed to$62.35

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.92 changed to 0.94
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $63.55changed to$63.38

    • 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

    $65.13changed to$63.55

    • 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 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $65.18changed to$65.13

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $65.11changed to$65.18

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $64.05changed to$65.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.85 changed to 0.88
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $64.85changed to$64.05

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.87 changed to 0.85
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $64.72changed to$64.85

    • 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

    $64.39changed to$64.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $69.37changed to$64.39

    • 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 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $68.09changed to$69.37

    • 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 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $68.09

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$61.40$39.62RVU26D
2026-07-01$61.40$39.62RVU26C
2026-04-01$61.40$39.62RVU26B
2026-01-01$61.40$39.62RVU26A
2025-10-01$60.42$46.30RVU25D
2025-07-01$60.42$46.30RVU25C
2025-04-01$60.42$46.30RVU25B
2025-01-01$60.42$46.30RVU25A
2024-10-01$61.84$46.98RVU24D
2024-07-01$61.84$46.98RVU24C
2024-04-01$61.84$46.98RVU24B
2024-03-09$61.84$46.98RVU24AR
2024-01-01$60.83$46.22RVU24A
2023-10-01$62.35$47.34RVU23D
2023-07-01$62.35$47.34RVU23C
2023-04-01$62.35$47.34RVU23B
2023-01-01$62.35$47.34RVU23A
2022-10-01$63.38$48.18RVU22D
2022-07-01$63.38$48.18RVU22C
2022-04-01$63.38$48.18RVU22B
2022-01-01$63.38$48.18RVU22A
2021-10-01$63.55$48.58RVU21D
2021-07-01$63.55$48.58RVU21C
2021-04-01$63.55$48.58RVU21B
2021-01-01$63.55$48.58RVU21A
2020-10-01$65.13$51.13RVU20D
2020-07-01$65.13$51.13RVU20C
2020-04-01$65.13$51.13RVU20B
2020-01-01$65.13$51.13RVU20A
2019-10-01$65.18$51.59RVU19D
2019-07-01$65.18$51.59RVU19C
2019-04-01$65.18$51.59RVU19B
2019-01-01$65.18$51.59RVU19A
2018-10-01$65.11$51.90RVU18D
2018-07-01$65.11$51.90RVU18C
2018-04-01$65.11$51.90RVU18B
2018-01-01$65.11$51.90RVU18AR1
2017-10-01$64.05$52.28RVU17D
2017-07-01$64.05$52.28RVU17C
2017-04-01$64.05$52.28RVU17B
2017-01-01$64.05$52.28RVU17A
2016-10-01$64.85$52.67RVU16D
2016-07-01$64.85$52.67RVU16C
2016-04-01$64.85$52.67RVU16B
2016-01-01$64.85$52.67RVU16A
2015-10-01$64.72$52.86RVU15D
2015-07-01$64.72$52.86RVU15C
2015-04-01$64.39$52.60RVU15B
2015-01-01$64.39$52.60RVU15A
2014-10-01$69.37$57.10RVU14D
2014-07-01$69.37$57.10RVU14C
2014-04-01$69.37$57.10RVU14B
2014-01-01$69.37$57.10RVU14A
2013-10-01$68.09$55.30RVU13D
2013-07-01$68.09$55.30RVU13C
2013-04-01$68.09$55.30RVU13B
2013-01-01$68.09$55.30RVU13AR

Price 68040 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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