CPT code 68100: Conjunctival biopsy, diagnostic tissue sampling2026 Medicare rate & RVUs in South Carolina
Reports sampling of conjunctival tissue for pathologic evaluation, commonly when an ocular surface abnormality requires diagnosis rather than complete removal.
In South Carolina, Medicare pays $169.12 for 68100 in the office and $78.07 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.
On this page 11 sections
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 South Carolina 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. South Carolina pays $169.12. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$169.12
- Los Angeles, CA · California$204.41+$35.29
- Washington, DC area · District of Columbia$205.98+$36.86
- Miami, FL · Florida$190.72+$21.60
- Chicago, IL · Illinois$185.42+$16.30
- Manhattan, NY · New York$206.04+$36.92
- Alaska · Alaska$208.67+$39.55
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $161.61 | $75.39 |
| ArkansasArkansas | $159.31 | $74.67 |
| ArizonaArizona | $175.08 | $79.60 |
| Bakersfield, CACalifornia | $191.76 | $83.77 |
| Chico, CACalifornia | $191.41 | $83.42 |
| El Centro, CACalifornia | $191.43 | $83.43 |
| Fresno, CACalifornia | $191.41 | $83.42 |
| Hanford, CACalifornia | $191.41 | $83.42 |
| Madera, CACalifornia | $191.41 | $83.42 |
| Merced, CACalifornia | $191.41 | $83.42 |
| Modesto, CACalifornia | $191.41 | $83.42 |
| Napa, CACalifornia | $222.62 | $92.76 |
| Oxnard, CACalifornia | $203.56 | $87.09 |
| Redding, CACalifornia | $191.41 | $83.42 |
| Rest of CaliforniaCalifornia | $191.41 | $83.42 |
| Riverside, CACalifornia | $192.62 | $84.62 |
| Sacramento, CACalifornia | $201.08 | $86.49 |
| Salinas, CACalifornia | $200.34 | $86.14 |
| San Diego, CACalifornia | $205.20 | $87.35 |
| Marin County, CACalifornia | $235.99 | $97.06 |
| San Francisco, CACalifornia | $235.87 | $96.93 |
| San Benito County, CACalifornia | $241.16 | $99.07 |
| Santa Clara County, CACalifornia | $240.65 | $98.56 |
| San Luis Obispo, CACalifornia | $197.08 | $84.85 |
| Santa Cruz, CACalifornia | $207.28 | $87.57 |
| Santa Maria, CACalifornia | $201.13 | $86.24 |
| Santa Rosa, CACalifornia | $209.40 | $88.40 |
| Stockton, CACalifornia | $191.41 | $83.42 |
| Vallejo, CACalifornia | $222.44 | $92.58 |
| Visalia, CACalifornia | $191.41 | $83.42 |
| Yuba City, CACalifornia | $191.41 | $83.42 |
| ColoradoColorado | $187.87 | $83.03 |
| ConnecticutConnecticut | $191.51 | $85.39 |
| DelawareDelaware | $177.96 | $80.61 |
| Fort Lauderdale, FLFlorida | $184.38 | $84.57 |
| Rest of FloridaFlorida | $175.74 | $81.54 |
| Atlanta, GAGeorgia | $182.68 | $82.57 |
| Rest of GeorgiaGeorgia | $166.15 | $78.26 |
| Hawaii, Guam, HIHawaii | $196.22 | $84.19 |
| IowaIowa | $166.27 | $76.11 |
| IdahoIdaho | $167.21 | $76.56 |
| East St. Louis, ILIllinois | $172.87 | $82.22 |
| Rest of IllinoisIllinois | $170.29 | $80.33 |
| Suburban Chicago, ILIllinois | $186.40 | $85.21 |
| IndianaIndiana | $168.18 | $76.84 |
| KansasKansas | $165.21 | $76.14 |
| KentuckyKentucky | $164.74 | $77.14 |
| New Orleans, LALouisiana | $172.41 | $79.69 |
| Rest of LouisianaLouisiana | $164.37 | $77.17 |
| Metropolitan Boston, MAMassachusetts | $206.70 | $89.05 |
| Rest of MassachusettsMassachusetts | $186.65 | $82.89 |
| Baltimore area, MDMaryland | $190.90 | $85.18 |
| Rest of MarylandMaryland | $181.42 | $81.70 |
| Rest of MaineMaine | $167.75 | $77.10 |
| Southern Maine, MEMaine | $177.15 | $79.51 |
| Detroit, MIMichigan | $177.60 | $82.52 |
| Rest of MichiganMichigan | $168.69 | $78.73 |
| MinnesotaMinnesota | $180.94 | $79.55 |
| Metropolitan Kansas City, MOMissouri | $171.56 | $79.04 |
| Metropolitan St. Louis, MOMissouri | $173.37 | $79.57 |
| Rest of MissouriMissouri | $161.39 | $76.46 |
| MississippiMississippi | $160.40 | $75.56 |
| MontanaMontana | $179.69 | $81.16 |
| North CarolinaNorth Carolina | $169.53 | $77.60 |
| North DakotaNorth Dakota | $177.51 | $78.98 |
| NebraskaNebraska | $167.25 | $76.31 |
| New HampshireNew Hampshire | $184.65 | $82.07 |
| Northern New JerseyNew Jersey | $203.83 | $89.54 |
| Rest of New JerseyNew Jersey | $193.95 | $86.36 |
| New MexicoNew Mexico | $169.48 | $79.13 |
| NevadaNevada | $179.22 | $80.58 |
| NYC suburbs and Long Island, NYNew York | $210.60 | $93.45 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $194.99 | $87.09 |
| Queens, NYNew York | $208.15 | $91.69 |
| Rest of New YorkNew York | $172.01 | $78.40 |
| OhioOhio | $168.25 | $78.29 |
| OklahomaOklahoma | $164.76 | $76.77 |
| Portland, OROregon | $194.11 | $84.64 |
| Rest of OregonOregon | $178.08 | $79.94 |
| Metropolitan Philadelphia, PAPennsylvania | $186.61 | $84.04 |
| Rest of PennsylvaniaPennsylvania | $168.68 | $78.22 |
| Puerto RicoPuerto Rico | $181.09 | $81.48 |
| Rhode IslandRhode Island | $184.49 | $82.71 |
| South DakotaSouth Dakota | $177.26 | $78.72 |
| TennesseeTennessee | $165.99 | $76.42 |
| Austin, TXTexas | $187.02 | $82.77 |
| Beaumont, TXTexas | $167.56 | $77.90 |
| Brazoria, TXTexas | $178.05 | $80.41 |
| Dallas, TXTexas | $179.04 | $80.91 |
| Fort Worth, TXTexas | $177.77 | $80.62 |
| Galveston, TXTexas | $178.49 | $80.65 |
| Houston, TXTexas | $180.51 | $82.66 |
| Rest of TexasTexas | $172.61 | $79.10 |
| UtahUtah | $171.41 | $78.79 |
| VirginiaVirginia | $176.37 | $79.52 |
| Virgin Islands, VIUnited States Virgin Islands | $181.09 | $81.48 |
| VermontVermont | $176.56 | $79.02 |
| Rest of WashingtonWashington | $186.38 | $82.63 |
| King County, WAWashington | $211.18 | $90.28 |
| WisconsinWisconsin | $171.61 | $77.22 |
| West VirginiaWest Virginia | $164.00 | $78.37 |
| WyomingWyoming | $178.74 | $80.21 |
68100 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.
$159.31
$216.29
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 | $208.67 | 1 |
| AL | $161.61 | 1 |
| AR | $159.31 | 1 |
| AZ | $175.08 | 1 |
| CA | $191.41–$241.16 | 29 |
| CO | $187.87 | 1 |
| CT | $191.51 | 1 |
| DC | $205.98 | 1 |
| DE | $177.96 | 1 |
| FL | $175.74–$190.72 | 3 |
| GA | $166.15–$182.68 | 2 |
| GU | $196.22 | 1 |
| HI | $196.22 | 1 |
| IA | $166.27 | 1 |
| ID | $167.21 | 1 |
| IL | $170.29–$186.40 | 4 |
| IN | $168.18 | 1 |
| KS | $165.21 | 1 |
| KY | $164.74 | 1 |
| LA | $164.37–$172.41 | 2 |
| MA | $186.65–$206.70 | 2 |
| MD | $181.42–$205.98 | 3 |
| ME | $167.75–$177.15 | 2 |
| MI | $168.69–$177.60 | 2 |
| MN | $180.94 | 1 |
| MO | $161.39–$173.37 | 3 |
| MS | $160.40 | 1 |
| MT | $179.69 | 1 |
| NC | $169.53 | 1 |
| ND | $177.51 | 1 |
| NE | $167.25 | 1 |
| NH | $184.65 | 1 |
| NJ | $193.95–$203.83 | 2 |
| NM | $169.48 | 1 |
| NV | $179.22 | 1 |
| NY | $172.01–$210.60 | 5 |
| OH | $168.25 | 1 |
| OK | $164.76 | 1 |
| OR | $178.08–$194.11 | 2 |
| PA | $168.68–$186.61 | 2 |
| PR | $181.09 | 1 |
| RI | $184.49 | 1 |
| SC | $169.12 | 1 |
| SD | $177.26 | 1 |
| TN | $165.99 | 1 |
| TX | $167.56–$187.02 | 8 |
| UT | $171.41 | 1 |
| VA | $176.37–$205.98 | 2 |
| VI | $181.09 | 1 |
| VT | $176.56 | 1 |
| WA | $186.38–$211.18 | 2 |
| WI | $171.61 | 1 |
| WV | $164.00 | 1 |
| WY | $178.74 | 1 |
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.
How the rate is built · 68100
RVUs × geographic indexes × conversion factor
Work1.32
1.32 RVUs× 1.000 GPCI
Practice expense3.95
3.95 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
5.3800
Conversion factor
$33.4009
Medicare rate
$179.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,535
- Code
- 68100
- Physician work
- 1.32
- Practice expense
- 3.95
- Malpractice
- 0.11
GPCI2026.csv
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.32 | × 1.000 | 1.3200 |
| Practice expense | 3.95 | × 0.924 | 3.6498 |
| Malpractice | 0.11 | × 0.850 | 0.0935 |
| Total RVUs | 5.0633 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$169.12
Office: (1.32 × 1 + 3.95 × 0.924 + 0.11 × 0.85) × $33.4009 = $169.12
Facility: (1.32 × 1 + 1 × 0.924 + 0.11 × 0.85) × $33.4009 = $78.07
Payment rules and modifiers for 68100
The CMS indicators that decide how 68100 is paid alongside other services.
CMS payment indicators · 68100
Conjunctival biopsy, diagnostic tissue sampling
| 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
68100 without 50 · national office
$179.70
Conjunctival biopsy, diagnostic tissue sampling
68100-50 · Bilateral: 150%
$269.55
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 68100 has changed in South Carolina
68100 · Office / nonfacility
$169.12
Effective 2026-10-01
The base rate is $10.06 higher than on 2025-10-01, moving from $159.06 to $169.12 (6.3%).
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
$159.06changed to$169.12
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.35 changed to 1.32
- Practice expense RVU 3.80 changed to 3.95
- Malpractice RVU 0.12 changed to 0.11
- Practice expense GPCI 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$166.76changed to$159.06
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.91 changed to 3.80
- Malpractice RVU 0.11 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$164.04changed to$166.76
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$169.18changed to$164.04
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.92 changed to 3.91
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$171.86changed to$169.18
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$173.29changed to$171.86
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$169.04changed to$173.29
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.60 changed to 3.92
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$166.34changed to$169.04
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.52 changed to 3.60
- Malpractice RVU 0.10 changed to 0.11
- Practice expense GPCI 0.912 changed to 0.907
- Malpractice GPCI 0.553 changed to 0.624
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$163.20changed to$166.34
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.43 changed to 3.52
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$160.04changed to$163.20
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.34 changed to 3.43
- Malpractice GPCI 0.634 changed to 0.553
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$159.96changed to$160.04
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.715 changed to 0.634
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$160.21changed to$159.96
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.33 changed to 3.34
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$159.41changed to$160.21
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$160.59changed to$159.41
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.31 changed to 3.33
- Malpractice RVU 0.19 changed to 0.10
- Practice expense GPCI 0.911 changed to 0.912
- Malpractice GPCI 0.618 changed to 0.715
Held through RVU15B.
January 1, 2014
RVU14A
$162.66changed to$160.59
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.66 changed to 3.31
- Malpractice RVU 0.20 changed to 0.19
- Practice expense GPCI 0.909 changed to 0.911
- Malpractice GPCI 0.520 changed to 0.618
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $162.66
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $169.12 | $78.07 | RVU26D |
| 2026-07-01 | $169.12 | $78.07 | RVU26C |
| 2026-04-01 | $169.12 | $78.07 | RVU26B |
| 2026-01-01 | $169.12 | $78.07 | RVU26A |
| 2025-10-01 | $159.06 | $87.89 | RVU25D |
| 2025-07-01 | $159.06 | $87.89 | RVU25C |
| 2025-04-01 | $159.06 | $87.89 | RVU25B |
| 2025-01-01 | $159.06 | $87.89 | RVU25A |
| 2024-10-01 | $166.76 | $89.57 | RVU24D |
| 2024-07-01 | $166.76 | $89.57 | RVU24C |
| 2024-04-01 | $166.76 | $89.57 | RVU24B |
| 2024-03-09 | $166.76 | $89.57 | RVU24AR |
| 2024-01-01 | $164.04 | $88.10 | RVU24A |
| 2023-10-01 | $169.18 | $89.80 | RVU23D |
| 2023-07-01 | $169.18 | $89.80 | RVU23C |
| 2023-04-01 | $169.18 | $89.80 | RVU23B |
| 2023-01-01 | $169.18 | $89.80 | RVU23A |
| 2022-10-01 | $171.86 | $89.68 | RVU22D |
| 2022-07-01 | $171.86 | $89.68 | RVU22C |
| 2022-04-01 | $171.86 | $89.68 | RVU22B |
| 2022-01-01 | $171.86 | $89.68 | RVU22A |
| 2021-10-01 | $173.29 | $90.42 | RVU21D |
| 2021-07-01 | $173.29 | $90.42 | RVU21C |
| 2021-04-01 | $173.29 | $90.42 | RVU21B |
| 2021-01-01 | $173.29 | $90.42 | RVU21A |
| 2020-10-01 | $169.04 | $92.44 | RVU20D |
| 2020-07-01 | $169.04 | $92.44 | RVU20C |
| 2020-04-01 | $169.04 | $92.44 | RVU20B |
| 2020-01-01 | $169.04 | $92.44 | RVU20A |
| 2019-10-01 | $166.34 | $93.37 | RVU19D |
| 2019-07-01 | $166.34 | $93.37 | RVU19C |
| 2019-04-01 | $166.34 | $93.37 | RVU19B |
| 2019-01-01 | $166.34 | $93.37 | RVU19A |
| 2018-10-01 | $163.20 | $94.26 | RVU18D |
| 2018-07-01 | $163.20 | $94.26 | RVU18C |
| 2018-04-01 | $163.20 | $94.26 | RVU18B |
| 2018-01-01 | $163.20 | $94.26 | RVU18AR1 |
| 2017-10-01 | $160.04 | $93.93 | RVU17D |
| 2017-07-01 | $160.04 | $93.93 | RVU17C |
| 2017-04-01 | $160.04 | $93.93 | RVU17B |
| 2017-01-01 | $160.04 | $93.93 | RVU17A |
| 2016-10-01 | $159.96 | $93.67 | RVU16D |
| 2016-07-01 | $159.96 | $93.67 | RVU16C |
| 2016-04-01 | $159.96 | $93.67 | RVU16B |
| 2016-01-01 | $159.96 | $93.67 | RVU16A |
| 2015-10-01 | $160.21 | $94.01 | RVU15D |
| 2015-07-01 | $160.21 | $94.01 | RVU15C |
| 2015-04-01 | $159.41 | $93.54 | RVU15B |
| 2015-01-01 | $159.41 | $93.54 | RVU15A |
| 2014-10-01 | $160.59 | $95.32 | RVU14D |
| 2014-07-01 | $160.59 | $95.32 | RVU14C |
| 2014-04-01 | $160.59 | $95.32 | RVU14B |
| 2014-01-01 | $160.59 | $95.32 | RVU14A |
| 2013-10-01 | $162.66 | $94.31 | RVU13D |
| 2013-07-01 | $162.66 | $94.31 | RVU13C |
| 2013-04-01 | $162.66 | $94.31 | RVU13B |
| 2013-01-01 | $162.66 | $94.31 | RVU13AR |
Where the South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
68100 billing questions
How does 68100 differ from 68110?
68100 represents sampling tissue to establish a diagnosis. 68110 represents excision of a conjunctival lesion smaller than 1 cm, when the service is lesion removal rather than a diagnostic sample.
Can the pathology examination be billed separately?
68100 represents obtaining the conjunctival specimen. The pathologist’s examination is a separate service and may be reported under the applicable surgical pathology code when performed.
How is a biopsy performed on both eyes reported?
Report modifier 50 when the service is bilateral and document the biopsy on each eye. CMS pays the bilateral procedure at 150%.
Is same-day preoperative or postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care for the biopsy.
What happens when 68100 is performed with other procedures?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
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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