CPT code 68100: Conjunctival biopsy, diagnostic tissue sampling2026 Medicare rate & RVUs in Napa, CA

In Napa, CA, Medicare pays $222.62 for 68100 in the office and $92.76 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 68100 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 68100 covers

Code 68100 represents removal of a conjunctival tissue sample for diagnostic examination rather than treatment by complete lesion removal. Ophthalmologists commonly use it for a suspicious conjunctival growth, pigmented area, or persistent abnormal tissue when histology is needed. The biopsy may be performed in an office or facility, and the specimen is submitted for pathologic evaluation.

Choose this service when tissue is sampled to establish a diagnosis; do not select an excision code solely because the sampled area has a particular size. The procedure note should identify the eye and conjunctival site, the tissue sampled, and the diagnostic purpose; document both eyes when bilateral. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay assistant-at-surgery services; 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 Napa, CA compares for 68100

Across 109 of 109 payment localities, the office rate for 68100 runs from $159.31 in Arkansas to $241.16 in San Benito County, CA. Napa, CA pays $222.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

68100 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 68100 in every payment locality

How the 68100 rate is calculated

Each of 68100’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.

Payment rules and modifiers for 68100

The CMS indicators that decide how 68100 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

Codes related to 68100

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

How 68100 has changed in Napa, CA

Price 68100 for an earlier date of service

Where the Napa, CA rate applies

Napa, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

• Napa
• American Canyon
• Angwin
• Calistoga
• Deer Park
• Moskowite Corner
• Oakville
• Rutherford

Browse all communities in California

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

Open CMS sourceHow we calculate rates