CPT code 68040: Eyelid lesion treatment, without incision, excluding chalazion2026 Medicare rate & RVUs in South Dakota
Reports nonincisional treatment of an eyelid lesion, such as molluscum contagiosum, when the lesion is treated rather than biopsied or excised.
In South Dakota, Medicare pays $60.90 for 68040 in the office and $38.86 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $60.90. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$60.90
- Los Angeles, CA · California$68.47+$7.57
- Washington, DC area · District of Columbia$69.27+$8.37
- Miami, FL · Florida$65.18+$4.28
- Chicago, IL · Illinois$63.88+$2.98
- Manhattan, NY · New York$69.65+$8.75
- Alaska · Alaska$77.18+$16.28
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $64.79 | $40.62 |
| Merced, CACalifornia | $64.79 | $40.62 |
| Modesto, CACalifornia | $64.79 | $40.62 |
| Napa, CACalifornia | $73.29 | $44.24 |
| Oxnard, CACalifornia | $68.02 | $41.96 |
| Redding, CACalifornia | $64.79 | $40.62 |
| Rest of CaliforniaCalifornia | $64.79 | $40.62 |
| Riverside, CACalifornia | $65.24 | $41.08 |
| Sacramento, CACalifornia | $67.51 | $41.87 |
| Salinas, CACalifornia | $67.24 | $41.69 |
| San Diego, CACalifornia | $68.43 | $42.06 |
| Marin County, CACalifornia | $77.12 | $46.04 |
| San Francisco, CACalifornia | $77.08 | $45.99 |
| San Benito County, CACalifornia | $78.69 | $46.90 |
| Santa Clara County, CACalifornia | $78.50 | $46.72 |
| San Luis Obispo, CACalifornia | $66.19 | $41.08 |
| Santa Cruz, CACalifornia | $68.79 | $42.01 |
| Santa Maria, CACalifornia | $67.38 | $41.68 |
| Santa Rosa, CACalifornia | $69.47 | $42.40 |
| Stockton, CACalifornia | $64.79 | $40.62 |
| Vallejo, CACalifornia | $73.22 | $44.17 |
| Visalia, CACalifornia | $64.79 | $40.62 |
| Yuba City, CACalifornia | $64.79 | $40.62 |
| ColoradoColorado | $63.93 | $40.47 |
| ConnecticutConnecticut | $65.15 | $41.41 |
| DelawareDelaware | $61.40 | $39.62 |
| Fort Lauderdale, FLFlorida | $63.30 | $40.97 |
| Rest of FloridaFlorida | $61.02 | $39.95 |
| Atlanta, GAGeorgia | $62.67 | $40.27 |
| Rest of GeorgiaGeorgia | $58.51 | $38.85 |
| Hawaii, Guam, HIHawaii | $65.71 | $40.65 |
| IowaIowa | $58.20 | $38.03 |
| IdahoIdaho | $58.47 | $38.19 |
| East St. Louis, ILIllinois | $60.53 | $40.25 |
| Rest of IllinoisIllinois | $59.70 | $39.57 |
| Suburban Chicago, ILIllinois | $63.90 | $41.26 |
| IndianaIndiana | $58.72 | $38.28 |
| KansasKansas | $57.99 | $38.06 |
| KentuckyKentucky | $58.04 | $38.45 |
| New Orleans, LALouisiana | $60.04 | $39.30 |
| Rest of LouisianaLouisiana | $57.97 | $38.46 |
| Metropolitan Boston, MAMassachusetts | $69.13 | $42.81 |
| Rest of MassachusettsMassachusetts | $63.70 | $40.49 |
| Baltimore area, MDMaryland | $64.94 | $41.29 |
| Rest of MarylandMaryland | $62.35 | $40.04 |
| Rest of MaineMaine | $58.67 | $38.39 |
| Southern Maine, MEMaine | $61.00 | $39.16 |
| Detroit, MIMichigan | $61.56 | $40.29 |
| Rest of MichiganMichigan | $59.12 | $38.99 |
| MinnesotaMinnesota | $61.80 | $39.12 |
| Metropolitan Kansas City, MOMissouri | $59.76 | $39.06 |
| Metropolitan St. Louis, MOMissouri | $60.22 | $39.24 |
| Rest of MissouriMissouri | $57.24 | $38.24 |
| MississippiMississippi | $56.89 | $37.91 |
| MontanaMontana | $61.79 | $39.74 |
| North CarolinaNorth Carolina | $59.12 | $38.55 |
| North DakotaNorth Dakota | $61.00 | $38.95 |
| NebraskaNebraska | $58.44 | $38.09 |
| New HampshireNew Hampshire | $62.97 | $40.02 |
| Northern New JerseyNew Jersey | $68.87 | $43.29 |
| Rest of New JerseyNew Jersey | $66.04 | $41.97 |
| New MexicoNew Mexico | $59.34 | $39.13 |
| NevadaNevada | $61.60 | $39.53 |
| NYC suburbs and Long Island, NYNew York | $70.90 | $44.69 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $66.43 | $42.29 |
| Queens, NYNew York | $70.11 | $44.06 |
| Rest of New YorkNew York | $59.76 | $38.82 |
| OhioOhio | $58.95 | $38.83 |
| OklahomaOklahoma | $57.99 | $38.31 |
| Portland, OROregon | $65.53 | $41.04 |
| Rest of OregonOregon | $61.26 | $39.31 |
| Metropolitan Philadelphia, PAPennsylvania | $63.89 | $40.94 |
| Rest of PennsylvaniaPennsylvania | $59.03 | $38.80 |
| Puerto RicoPuerto Rico | $62.13 | $39.84 |
| Rhode IslandRhode Island | $63.25 | $40.48 |
| South CarolinaSouth Carolina | $59.10 | $38.73 |
| TennesseeTennessee | $58.19 | $38.16 |
| Austin, TXTexas | $63.59 | $40.27 |
| Beaumont, TXTexas | $58.75 | $38.69 |
| Brazoria, TXTexas | $61.42 | $39.58 |
| Dallas, TXTexas | $61.72 | $39.76 |
| Fort Worth, TXTexas | $61.41 | $39.67 |
| Galveston, TXTexas | $61.55 | $39.66 |
| Houston, TXTexas | $62.29 | $40.40 |
| Rest of TexasTexas | $59.99 | $39.07 |
| UtahUtah | $59.69 | $38.97 |
| VirginiaVirginia | $60.84 | $39.17 |
| Virgin Islands, VIUnited States Virgin Islands | $62.13 | $39.84 |
| VermontVermont | $60.80 | $38.98 |
| Rest of WashingtonWashington | $63.57 | $40.35 |
| King County, WAWashington | $70.36 | $43.31 |
| WisconsinWisconsin | $59.49 | $38.37 |
| West VirginiaWest Virginia | $58.08 | $38.92 |
| WyomingWyoming | $61.44 | $39.40 |
68040 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $77.18 | 1 |
| AL | $57.12 | 1 |
| AR | $56.53 | 1 |
| AZ | $60.58 | 1 |
| CA | $64.79–$78.69 | 29 |
| CO | $63.93 | 1 |
| CT | $65.15 | 1 |
| DC | $69.27 | 1 |
| DE | $61.40 | 1 |
| FL | $61.02–$65.18 | 3 |
| GA | $58.51–$62.67 | 2 |
| GU | $65.71 | 1 |
| HI | $65.71 | 1 |
| IA | $58.20 | 1 |
| ID | $58.47 | 1 |
| IL | $59.70–$63.90 | 4 |
| IN | $58.72 | 1 |
| KS | $57.99 | 1 |
| KY | $58.04 | 1 |
| LA | $57.97–$60.04 | 2 |
| MA | $63.70–$69.13 | 2 |
| MD | $62.35–$69.27 | 3 |
| ME | $58.67–$61.00 | 2 |
| MI | $59.12–$61.56 | 2 |
| MN | $61.80 | 1 |
| MO | $57.24–$60.22 | 3 |
| MS | $56.89 | 1 |
| MT | $61.79 | 1 |
| NC | $59.12 | 1 |
| ND | $61.00 | 1 |
| NE | $58.44 | 1 |
| NH | $62.97 | 1 |
| NJ | $66.04–$68.87 | 2 |
| NM | $59.34 | 1 |
| NV | $61.60 | 1 |
| NY | $59.76–$70.90 | 5 |
| OH | $58.95 | 1 |
| OK | $57.99 | 1 |
| OR | $61.26–$65.53 | 2 |
| PA | $59.03–$63.89 | 2 |
| PR | $62.13 | 1 |
| RI | $63.25 | 1 |
| SC | $59.10 | 1 |
| SD | $60.90 | 1 |
| TN | $58.19 | 1 |
| TX | $58.75–$63.59 | 8 |
| UT | $59.69 | 1 |
| VA | $60.84–$69.27 | 2 |
| VI | $62.13 | 1 |
| VT | $60.80 | 1 |
| WA | $63.57–$70.36 | 2 |
| WI | $59.49 | 1 |
| WV | $58.08 | 1 |
| WY | $61.44 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 0.98 | × 1.000 | 0.9800 |
| Malpractice | 0.04 | × 0.336 | 0.0134 |
| Total RVUs | 1.8234 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$60.90
Office: (0.83 × 1 + 0.98 × 1 + 0.04 × 0.336) × $33.4009 = $60.90
Facility: (0.83 × 1 + 0.32 × 1 + 0.04 × 0.336) × $33.4009 = $38.86
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
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).
How 68040 has changed in South Dakota
68040 · Office / nonfacility
$60.90
Effective 2026-10-01
The base rate is $1.21 higher than on 2025-10-01, moving from $59.69 to $60.90 (2.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$59.69changed to$60.90
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.85 changed to 0.83
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$61.09changed to$59.69
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.97 changed to 0.98
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$60.09changed to$61.09
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$61.15changed to$60.09
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.94 changed to 0.97
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$61.73changed to$61.15
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.92 changed to 0.94
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$61.90changed to$61.73
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.91 changed to 0.92
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$63.10changed to$61.90
- 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
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$63.05changed to$63.10
- Conversion factor 36.0391 changed to 36.0896
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$62.98changed to$63.05
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$61.72changed to$62.98
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.85 changed to 0.88
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$62.30changed to$61.72
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.87 changed to 0.85
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$62.16changed to$62.30
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.86 changed to 0.87
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$61.86changed to$62.16
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$65.28changed to$61.86
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$64.95changed to$65.28
- 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
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $64.95
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $60.90 | $38.86 | RVU26D |
| 2026-07-01 | $60.90 | $38.86 | RVU26C |
| 2026-04-01 | $60.90 | $38.86 | RVU26B |
| 2026-01-01 | $60.90 | $38.86 | RVU26A |
| 2025-10-01 | $59.69 | $45.46 | RVU25D |
| 2025-07-01 | $59.69 | $45.46 | RVU25C |
| 2025-04-01 | $59.69 | $45.46 | RVU25B |
| 2025-01-01 | $59.69 | $45.46 | RVU25A |
| 2024-10-01 | $61.09 | $46.11 | RVU24D |
| 2024-07-01 | $61.09 | $46.11 | RVU24C |
| 2024-04-01 | $61.09 | $46.11 | RVU24B |
| 2024-03-09 | $61.09 | $46.11 | RVU24AR |
| 2024-01-01 | $60.09 | $45.36 | RVU24A |
| 2023-10-01 | $61.15 | $46.24 | RVU23D |
| 2023-07-01 | $61.15 | $46.24 | RVU23C |
| 2023-04-01 | $61.15 | $46.24 | RVU23B |
| 2023-01-01 | $61.15 | $46.24 | RVU23A |
| 2022-10-01 | $61.73 | $46.85 | RVU22D |
| 2022-07-01 | $61.73 | $46.85 | RVU22C |
| 2022-04-01 | $61.73 | $46.85 | RVU22B |
| 2022-01-01 | $61.73 | $46.85 | RVU22A |
| 2021-10-01 | $61.90 | $47.24 | RVU21D |
| 2021-07-01 | $61.90 | $47.24 | RVU21C |
| 2021-04-01 | $61.90 | $47.24 | RVU21B |
| 2021-01-01 | $61.90 | $47.24 | RVU21A |
| 2020-10-01 | $63.10 | $49.39 | RVU20D |
| 2020-07-01 | $63.10 | $49.39 | RVU20C |
| 2020-04-01 | $63.10 | $49.39 | RVU20B |
| 2020-01-01 | $63.10 | $49.39 | RVU20A |
| 2019-10-01 | $63.05 | $49.71 | RVU19D |
| 2019-07-01 | $63.05 | $49.71 | RVU19C |
| 2019-04-01 | $63.05 | $49.71 | RVU19B |
| 2019-01-01 | $63.05 | $49.71 | RVU19A |
| 2018-10-01 | $62.98 | $50.02 | RVU18D |
| 2018-07-01 | $62.98 | $50.02 | RVU18C |
| 2018-04-01 | $62.98 | $50.02 | RVU18B |
| 2018-01-01 | $62.98 | $50.02 | RVU18AR1 |
| 2017-10-01 | $61.72 | $50.24 | RVU17D |
| 2017-07-01 | $61.72 | $50.24 | RVU17C |
| 2017-04-01 | $61.72 | $50.24 | RVU17B |
| 2017-01-01 | $61.72 | $50.24 | RVU17A |
| 2016-10-01 | $62.30 | $50.48 | RVU16D |
| 2016-07-01 | $62.30 | $50.48 | RVU16C |
| 2016-04-01 | $62.30 | $50.48 | RVU16B |
| 2016-01-01 | $62.30 | $50.48 | RVU16A |
| 2015-10-01 | $62.16 | $50.67 | RVU15D |
| 2015-07-01 | $62.16 | $50.67 | RVU15C |
| 2015-04-01 | $61.86 | $50.41 | RVU15B |
| 2015-01-01 | $61.86 | $50.41 | RVU15A |
| 2014-10-01 | $65.28 | $53.46 | RVU14D |
| 2014-07-01 | $65.28 | $53.46 | RVU14C |
| 2014-04-01 | $65.28 | $53.46 | RVU14B |
| 2014-01-01 | $65.28 | $53.46 | RVU14A |
| 2013-10-01 | $64.95 | $52.71 | RVU13D |
| 2013-07-01 | $64.95 | $52.71 | RVU13C |
| 2013-04-01 | $64.95 | $52.71 | RVU13B |
| 2013-01-01 | $64.95 | $52.71 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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