FeeBase
Log inGet started
Menu

CPT code 68115: Conjunctival excision, lesion larger than 1 cm2026 Medicare rate & RVUs in Puerto Rico

Report surgical removal of a conjunctival lesion larger than 1 cm, such as a growth requiring excision rather than biopsy or destruction.

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

In Puerto Rico, Medicare pays $333.62 for 68115 in the office and $157.68 when it’s performed in a hospital or facility.

$333.62Office (non-facility)
$157.68Hospital or facility
+0.8%vs the national office rate ($331.00)

Check a contract rate as a % of Medicare · 68115 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 68115 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 68115 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 68115 covers

This service removes a lesion from the conjunctiva, the tissue lining the inner eyelids and covering the visible surface of the eye. Ophthalmologists commonly excise larger or suspicious ocular-surface growths in an office procedure room or surgical facility. The removed tissue may be submitted for pathologic examination; the code represents the excision itself, not the laboratory interpretation.

Choose this code when documentation supports a lesion larger than 1 cm and describes its size, location, laterality, and excision. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 Puerto Rico compares for 68115

Across 109 of 109 payment localities, the office rate for 68115 runs from $293.22 in Arkansas to $445.50 in San Benito County, CA. Puerto Rico pays $333.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

68115 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$333.62
  2. Los Angeles, CA · California$377.14+$43.52
  3. Washington, DC area · District of Columbia$379.78+$46.16
  4. Miami, FL · Florida$350.80+$17.18
  5. Chicago, IL · Illinois$341.00+$7.38
  6. Manhattan, NY · New York$379.62+$46.00
  7. Alaska · Alaska$383.40+$49.78

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

Every other payment area

68115 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$297.48$145.21
ArkansasArkansas$293.22$143.73
ArizonaArizona$322.46$153.83
Bakersfield, CACalifornia$353.64$162.92
Chico, CACalifornia$353.02$162.30
El Centro, CACalifornia$353.06$162.33
Fresno, CACalifornia$353.02$162.30
Hanford, CACalifornia$353.02$162.30

68115 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.

$293.22

$399.26

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

View every state and territory as a table
68115 office rate range by state
State / territoryOffice rate rangeLocalities
AK$383.401
AL$297.481
AR$293.221
AZ$322.461
CA$353.02–$445.5029
CO$346.311
CT$352.861
DC$379.781
DE$327.801
FL$323.36–$350.803
GA$305.64–$336.452
GU$362.061
HI$362.061
IA$306.251
ID$307.971
IL$313.16–$343.104
IN$309.771
KS$304.221
KY$303.141
LA$302.43–$317.342
MA$344.02–$381.282
MD$334.22–$379.783
ME$308.91–$326.452
MI$310.41–$326.742
MN$333.671
MO$296.87–$319.203
MS$295.131
MT$330.991
NC$312.221
ND$327.231
NE$308.101
NH$340.301
NJ$357.41–$375.772
NM$311.851
NV$330.191
NY$316.81–$387.995
OH$309.641
OK$303.251
OR$328.13–$357.962
PA$310.47–$343.732
PR$333.621
RI$339.931
SC$311.341
SD$326.791
TN$305.661
TX$308.40–$344.718
UT$315.591
VA$324.95–$379.782
VI$333.621
VT$325.411
WA$343.55–$389.652
WI$316.271
WV$301.491
WY$329.351

See 68115 in every payment locality

How the 68115 rate is calculated

Each of 68115’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 · 68115

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.35

2.35 RVUs× 1.000 GPCI

Practice expense7.37

7.37 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

9.9100

Conversion factor

$33.4009

Medicare rate

$331.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,537

Code
68115
Physician work
2.35
Practice expense
7.37
Malpractice
0.19

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 68115 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.35× 1.0002.3500
Practice expense7.37× 1.0117.4511
Malpractice0.19× 0.9850.1872
Total RVUs9.9882
Conversion factor× 33.4009

Office rate, Puerto Rico$333.62

Office: (2.35 × 1 + 7.37 × 1.011 + 0.19 × 0.985) × $33.4009 = $333.62

Facility: (2.35 × 1 + 2.16 × 1.011 + 0.19 × 0.985) × $33.4009 = $157.68

Open 68115 in the RVU calculator

Payment rules and modifiers for 68115

68115 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68115

Conjunctival excision, lesion larger than 1 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68115

Conjunctival excision, lesion larger than 1 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68115 without 50 · national office

$331.00

Conjunctival excision, lesion larger than 1 cm

68115-50 · Bilateral: 150%

$496.50

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 68115

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

Codes related to 68115
CodeHow it relatesOffice range, Puerto Rico
Same family
68110Conjunctival excision, lesion under 1 cmConjunctival lesion excision for a lesion smaller than 1 cm.$239.32
68130Conjunctival excision, adjacent sclera includedConjunctival lesion excision distinguished by its relationship to the sclera.$558.38
Used instead
68100Conjunctival biopsy, diagnostic tissue samplingBiopsy rather than excision of a larger conjunctival lesion.$181.09
68135Lesion destruction, conjunctivaDestruction of a conjunctival lesion rather than surgical excision.$160.61

How 68115 has changed in Puerto Rico

68115 · Office / nonfacility

$333.62

Effective 2026-10-01

The base rate is $18.03 higher than on 2025-10-01, moving from $315.59 to $333.62 (5.7%).

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

    $315.59changed to$333.62

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.41 changed to 2.35
    • Practice expense RVU 7.12 changed to 7.37
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $332.14changed to$315.59

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.33 changed to 7.12
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $326.72changed to$332.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $338.73changed to$326.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.34 changed to 7.33
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $336.84changed to$338.73

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $345.57changed to$336.84

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.32 changed to 7.34
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $349.15changed to$345.57

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.35 changed to 7.32
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $333.49changed to$349.15

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.60 changed to 7.35
    • Malpractice RVU 0.18 changed to 0.19
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $328.44changed to$333.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.48 changed to 6.60
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $321.92changed to$328.44

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.31 changed to 6.48

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $280.80changed to$321.92

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.19 changed to 6.31
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $244.68changed to$280.80

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.20 changed to 6.19
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $244.95changed to$244.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.18 changed to 6.20
    • Malpractice RVU 0.17 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $243.73changed to$244.95

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $241.70changed to$243.73

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.15 changed to 6.18
    • Malpractice RVU 0.30 changed to 0.17
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $241.25changed to$241.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.79 changed to 6.15
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $241.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$333.62$157.68RVU26D
2026-07-01$333.62$157.68RVU26C
2026-04-01$333.62$157.68RVU26B
2026-01-01$333.62$157.68RVU26A
2025-10-01$315.59$176.51RVU25D
2025-07-01$315.59$176.51RVU25C
2025-04-01$315.59$176.51RVU25B
2025-01-01$315.59$176.51RVU25A
2024-10-01$332.14$181.63RVU24D
2024-07-01$332.14$181.63RVU24C
2024-04-01$332.14$181.63RVU24B
2024-03-09$332.14$181.63RVU24AR
2024-01-01$326.72$178.67RVU24A
2023-10-01$338.73$182.96RVU23D
2023-07-01$336.84$182.31RVU23C
2023-04-01$336.84$182.31RVU23B
2023-01-01$336.84$182.31RVU23A
2022-10-01$345.57$183.71RVU22D
2022-07-01$345.57$183.71RVU22C
2022-04-01$345.57$183.71RVU22B
2022-01-01$345.57$183.71RVU22A
2021-10-01$349.15$184.54RVU21D
2021-07-01$349.15$184.54RVU21C
2021-04-01$349.15$184.54RVU21B
2021-01-01$349.15$184.54RVU21A
2020-10-01$333.49$187.61RVU20D
2020-07-01$333.49$187.61RVU20C
2020-04-01$333.49$187.61RVU20B
2020-01-01$333.49$187.61RVU20A
2019-10-01$328.44$189.09RVU19D
2019-07-01$328.44$189.09RVU19C
2019-04-01$328.44$189.09RVU19B
2019-01-01$328.44$189.09RVU19A
2018-10-01$321.92$189.60RVU18D
2018-07-01$321.92$189.60RVU18C
2018-04-01$321.92$189.60RVU18B
2018-01-01$321.92$189.60RVU18AR1
2017-10-01$280.80$171.43RVU17D
2017-07-01$280.80$171.43RVU17C
2017-04-01$280.80$171.43RVU17B
2017-01-01$280.80$171.43RVU17A
2016-10-01$244.68$154.56RVU16D
2016-07-01$244.68$154.56RVU16C
2016-04-01$244.68$154.56RVU16B
2016-01-01$244.68$154.56RVU16A
2015-10-01$244.95$155.02RVU15D
2015-07-01$244.95$155.02RVU15C
2015-04-01$243.73$154.24RVU15B
2015-01-01$243.73$154.24RVU15A
2014-10-01$241.70$154.44RVU14D
2014-07-01$241.70$154.44RVU14C
2014-04-01$241.70$154.44RVU14B
2014-01-01$241.70$154.44RVU14A
2013-10-01$241.25$150.59RVU13D
2013-07-01$241.25$150.59RVU13C
2013-04-01$241.25$150.59RVU13B
2013-01-01$241.25$150.59RVU13AR

Price 68115 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

68115 billing questions

How does this differ from 68110?

68115 is for an excised conjunctival lesion larger than 1 cm; 68110 is for a lesion smaller than 1 cm. Document the lesion’s size to support the selection.

When would 68100 be more appropriate?

68100 describes a conjunctival biopsy. Use it when the service is a biopsy rather than excision of a lesion larger than 1 cm.

Is pathologic examination included?

The code represents removal of the lesion, not the laboratory examination of the specimen. A separately performed pathology service may be reported by the appropriate provider.

How is bilateral excision reported?

For bilateral treatment, report modifier 50; the CMS bilateral rule pays this code at 150%.

Are related postoperative visits separately payable?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can an assistant or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this service. 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
RVUs for 68115PPRRVU2026_Oct_nonQPP.csv, line 7,537 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 68115 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 68115 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet