CPT code 68320: Conjunctivoplasty, graft or extensive rearrangement2026 Medicare rate & RVUs in Utah
Report this service when an ophthalmic surgeon reconstructs the conjunctival lining using a conjunctival graft or extensive tissue rearrangement.
In Utah, Medicare pays $714.60 for 68320 in the office and $452.43 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 68320 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 68320 covers
An ophthalmic surgeon uses this code to repair or reconstruct the conjunctival lining when a graft of conjunctival tissue or extensive rearrangement is needed. The work may address scarred or contracted tissue that interferes with the lining’s function, including changes associated with adhesions or ocular surface injury. It is performed in an ophthalmic surgical setting by a surgeon managing the affected eye and surrounding tissues.
Choose the code based on the documented reconstruction method and extent, distinguishing graft-based or extensive rearrangement from a procedure without grafting or a different graft type. The operative report should identify the affected area, the tissue used or rearranged, and the reconstructive work performed. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is 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 Utah compares for 68320
Across 109 of 109 payment localities, the office rate for 68320 runs from $666.44 in Arkansas to $990.25 in San Benito County, CA. Utah pays $714.60. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$714.60
- Los Angeles, CA · California$844.38+$129.78
- Washington, DC area · District of Columbia$852.27+$137.67
- Miami, FL · Florida$794.30+$79.70
- Chicago, IL · Illinois$773.32+$58.72
- Manhattan, NY · New York$854.27+$139.67
- Alaska · Alaska$880.99+$166.39
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $675.53 | $431.49 |
| ArkansasArkansas | $666.44 | $426.86 |
| ArizonaArizona | $728.79 | $458.54 |
| Bakersfield, CACalifornia | $793.97 | $488.30 |
| Chico, CACalifornia | $792.30 | $486.62 |
| El Centro, CACalifornia | $792.38 | $486.71 |
| Fresno, CACalifornia | $792.30 | $486.62 |
| Hanford, CACalifornia | $792.30 | $486.62 |
| Madera, CACalifornia | $792.30 | $486.62 |
| Merced, CACalifornia | $792.30 | $486.62 |
| Modesto, CACalifornia | $792.30 | $486.62 |
| Napa, CACalifornia | $915.88 | $548.29 |
| Oxnard, CACalifornia | $840.36 | $510.71 |
| Redding, CACalifornia | $792.30 | $486.62 |
| Rest of CaliforniaCalifornia | $792.30 | $486.62 |
| Riverside, CACalifornia | $797.91 | $492.24 |
| Sacramento, CACalifornia | $830.84 | $506.48 |
| Salinas, CACalifornia | $827.71 | $504.46 |
| San Diego, CACalifornia | $846.61 | $513.05 |
| Marin County, CACalifornia | $969.25 | $576.00 |
| San Francisco, CACalifornia | $968.67 | $575.42 |
| San Benito County, CACalifornia | $990.25 | $588.08 |
| Santa Clara County, CACalifornia | $987.88 | $585.71 |
| San Luis Obispo, CACalifornia | $814.40 | $496.74 |
| Santa Cruz, CACalifornia | $854.33 | $515.47 |
| Santa Maria, CACalifornia | $830.66 | $505.46 |
| Santa Rosa, CACalifornia | $862.96 | $520.47 |
| Stockton, CACalifornia | $792.30 | $486.62 |
| Vallejo, CACalifornia | $915.04 | $547.45 |
| Visalia, CACalifornia | $792.30 | $486.62 |
| Yuba City, CACalifornia | $792.30 | $486.62 |
| ColoradoColorado | $778.94 | $482.19 |
| ConnecticutConnecticut | $794.66 | $494.29 |
| DelawareDelaware | $740.37 | $464.82 |
| Fort Lauderdale, FLFlorida | $767.62 | $485.10 |
| Rest of FloridaFlorida | $733.13 | $466.50 |
| Atlanta, GAGeorgia | $759.48 | $476.12 |
| Rest of GeorgiaGeorgia | $694.93 | $446.16 |
| Hawaii, Guam, HIHawaii | $810.43 | $493.32 |
| IowaIowa | $693.21 | $438.02 |
| IdahoIdaho | $697.08 | $440.49 |
| East St. Louis, ILIllinois | $723.33 | $466.74 |
| Rest of IllinoisIllinois | $712.05 | $457.41 |
| Suburban Chicago, ILIllinois | $775.72 | $489.29 |
| IndianaIndiana | $700.90 | $442.36 |
| KansasKansas | $689.38 | $437.26 |
| KentuckyKentucky | $688.67 | $440.73 |
| New Orleans, LALouisiana | $719.17 | $456.72 |
| Rest of LouisianaLouisiana | $687.35 | $440.52 |
| Metropolitan Boston, MAMassachusetts | $853.89 | $520.88 |
| Rest of MassachusettsMassachusetts | $774.42 | $480.74 |
| Baltimore area, MDMaryland | $792.20 | $492.94 |
| Rest of MarylandMaryland | $754.11 | $471.87 |
| Rest of MaineMaine | $699.62 | $443.03 |
| Southern Maine, MEMaine | $736.27 | $459.88 |
| Detroit, MIMichigan | $740.87 | $471.74 |
| Rest of MichiganMichigan | $704.65 | $450.02 |
| MinnesotaMinnesota | $750.09 | $463.11 |
| Metropolitan Kansas City, MOMissouri | $715.43 | $453.55 |
| Metropolitan St. Louis, MOMissouri | $722.54 | $457.03 |
| Rest of MissouriMissouri | $675.80 | $435.39 |
| MississippiMississippi | $671.28 | $431.15 |
| MontanaMontana | $747.14 | $468.25 |
| North CarolinaNorth Carolina | $706.59 | $446.38 |
| North DakotaNorth Dakota | $737.06 | $458.16 |
| NebraskaNebraska | $697.00 | $439.58 |
| New HampshireNew Hampshire | $766.12 | $475.79 |
| Northern New JerseyNew Jersey | $844.20 | $520.68 |
| Rest of New JerseyNew Jersey | $804.77 | $500.21 |
| New MexicoNew Mexico | $707.94 | $452.19 |
| NevadaNevada | $744.85 | $465.67 |
| NYC suburbs and Long Island, NYNew York | $872.76 | $541.15 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $809.31 | $503.92 |
| Queens, NYNew York | $862.09 | $532.44 |
| Rest of New YorkNew York | $716.42 | $451.46 |
| OhioOhio | $702.59 | $447.96 |
| OklahomaOklahoma | $688.38 | $439.32 |
| Portland, OROregon | $803.33 | $493.48 |
| Rest of OregonOregon | $740.06 | $462.28 |
| Metropolitan Philadelphia, PAPennsylvania | $775.43 | $485.10 |
| Rest of PennsylvaniaPennsylvania | $704.09 | $448.06 |
| Puerto RicoPuerto Rico | $752.58 | $470.61 |
| Rhode IslandRhode Island | $766.41 | $478.31 |
| South CarolinaSouth Carolina | $705.56 | $447.85 |
| South DakotaSouth Dakota | $735.87 | $456.97 |
| TennesseeTennessee | $692.51 | $439.00 |
| Austin, TXTexas | $775.48 | $480.41 |
| Beaumont, TXTexas | $699.71 | $445.91 |
| Brazoria, TXTexas | $740.53 | $464.15 |
| Dallas, TXTexas | $744.65 | $466.87 |
| Fort Worth, TXTexas | $739.73 | $464.74 |
| Galveston, TXTexas | $742.38 | $465.43 |
| Houston, TXTexas | $751.71 | $474.77 |
| Rest of TexasTexas | $719.31 | $454.64 |
| VirginiaVirginia | $733.43 | $459.28 |
| Virgin Islands, VIUnited States Virgin Islands | $752.58 | $470.61 |
| VermontVermont | $733.62 | $457.51 |
| Rest of WashingtonWashington | $773.16 | $479.48 |
| King County, WAWashington | $871.55 | $529.35 |
| WisconsinWisconsin | $713.80 | $446.62 |
| West VirginiaWest Virginia | $687.18 | $444.82 |
| WyomingWyoming | $742.75 | $463.85 |
68320 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.
$666.44
$891.28
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 | $880.99 | 1 |
| AL | $675.53 | 1 |
| AR | $666.44 | 1 |
| AZ | $728.79 | 1 |
| CA | $792.30–$990.25 | 29 |
| CO | $778.94 | 1 |
| CT | $794.66 | 1 |
| DC | $852.27 | 1 |
| DE | $740.37 | 1 |
| FL | $733.13–$794.30 | 3 |
| GA | $694.93–$759.48 | 2 |
| GU | $810.43 | 1 |
| HI | $810.43 | 1 |
| IA | $693.21 | 1 |
| ID | $697.08 | 1 |
| IL | $712.05–$775.72 | 4 |
| IN | $700.90 | 1 |
| KS | $689.38 | 1 |
| KY | $688.67 | 1 |
| LA | $687.35–$719.17 | 2 |
| MA | $774.42–$853.89 | 2 |
| MD | $754.11–$852.27 | 3 |
| ME | $699.62–$736.27 | 2 |
| MI | $704.65–$740.87 | 2 |
| MN | $750.09 | 1 |
| MO | $675.80–$722.54 | 3 |
| MS | $671.28 | 1 |
| MT | $747.14 | 1 |
| NC | $706.59 | 1 |
| ND | $737.06 | 1 |
| NE | $697.00 | 1 |
| NH | $766.12 | 1 |
| NJ | $804.77–$844.20 | 2 |
| NM | $707.94 | 1 |
| NV | $744.85 | 1 |
| NY | $716.42–$872.76 | 5 |
| OH | $702.59 | 1 |
| OK | $688.38 | 1 |
| OR | $740.06–$803.33 | 2 |
| PA | $704.09–$775.43 | 2 |
| PR | $752.58 | 1 |
| RI | $766.41 | 1 |
| SC | $705.56 | 1 |
| SD | $735.87 | 1 |
| TN | $692.51 | 1 |
| TX | $699.71–$775.48 | 8 |
| UT | $714.60 | 1 |
| VA | $733.43–$852.27 | 2 |
| VI | $752.58 | 1 |
| VT | $733.62 | 1 |
| WA | $773.16–$871.55 | 2 |
| WI | $713.80 | 1 |
| WV | $687.18 | 1 |
| WY | $742.75 | 1 |
How the 68320 rate is calculated
Each of 68320’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 · 68320
RVUs × geographic indexes × conversion factor
Work6.47
6.47 RVUs× 1.000 GPCI
Practice expense15.39
15.39 RVUs× 1.000 GPCI
Malpractice0.51
0.51 RVUs× 1.000 GPCI
Adjusted RVUs
22.3700
Conversion factor
$33.4009
Medicare rate
$747.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Utah inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,541
- Code
- 68320
- Physician work
- 6.47
- Practice expense
- 15.39
- Malpractice
- 0.51
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.47 | × 1.000 | 6.4700 |
| Practice expense | 15.39 | × 0.940 | 14.4666 |
| Malpractice | 0.51 | × 0.898 | 0.4580 |
| Total RVUs | 21.3946 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Utah$714.60
Office: (6.47 × 1 + 15.39 × 0.94 + 0.51 × 0.898) × $33.4009 = $714.60
Facility: (6.47 × 1 + 7.04 × 0.94 + 0.51 × 0.898) × $33.4009 = $452.43
Payment rules and modifiers for 68320
68320 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68320
Conjunctivoplasty, graft or extensive rearrangement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68320
Conjunctivoplasty, graft or extensive rearrangement
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68320 without 50 · national office
$747.18
Conjunctivoplasty, graft or extensive rearrangement
68320-50 · Bilateral: 150%
$1,120.77
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 68320 has changed in Utah
68320 · Office / nonfacility
$714.60
Effective 2026-10-01
The base rate is $37.22 higher than on 2025-10-01, moving from $677.38 to $714.60 (5.5%).
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
$677.38changed to$714.60
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 6.64 changed to 6.47
- Practice expense RVU 14.80 changed to 15.39
- Malpractice RVU 0.53 changed to 0.51
- Practice expense GPCI 0.933 changed to 0.940
- Malpractice GPCI 0.930 changed to 0.898
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$704.54changed to$677.38
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 15.04 changed to 14.80
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$693.04changed to$704.54
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$709.67changed to$693.04
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 14.95 changed to 15.04
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.865 changed to 0.930
January 1, 2023
RVU23A
$714.13changed to$709.67
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 14.76 changed to 14.95
- Malpractice RVU 0.54 changed to 0.53
- Practice expense GPCI 0.919 changed to 0.926
- Malpractice GPCI 0.799 changed to 0.865
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$721.14changed to$714.13
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 14.82 changed to 14.76
- Malpractice RVU 0.51 changed to 0.54
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$715.09changed to$721.14
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 13.72 changed to 14.82
- Malpractice RVU 0.52 changed to 0.51
- Practice expense GPCI 0.923 changed to 0.919
- Malpractice GPCI 0.982 changed to 0.799
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$717.32changed to$715.09
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 13.68 changed to 13.72
- Malpractice RVU 0.50 changed to 0.52
- Practice expense GPCI 0.927 changed to 0.923
- Malpractice GPCI 1.165 changed to 0.982
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$711.53changed to$717.32
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 13.53 changed to 13.68
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$701.43changed to$711.53
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 13.32 changed to 13.53
- Practice expense GPCI 0.925 changed to 0.927
- Malpractice GPCI 1.167 changed to 1.165
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$698.05changed to$701.43
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 13.31 changed to 13.32
- Practice expense GPCI 0.922 changed to 0.925
- Malpractice GPCI 1.169 changed to 1.167
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$699.82changed to$698.05
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 13.30 changed to 13.31
- Malpractice RVU 0.49 changed to 0.50
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$696.34changed to$699.82
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$723.79changed to$696.34
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 13.24 changed to 13.30
- Malpractice RVU 1.23 changed to 0.49
- Practice expense GPCI 0.919 changed to 0.922
- Malpractice GPCI 1.136 changed to 1.169
Held through RVU15B.
January 1, 2014
RVU14A
$728.67changed to$723.79
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 14.58 changed to 13.24
- Malpractice RVU 1.29 changed to 1.23
- Practice expense GPCI 0.916 changed to 0.919
- Malpractice GPCI 1.102 changed to 1.136
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $728.67
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $714.60 | $452.43 | RVU26D |
| 2026-07-01 | $714.60 | $452.43 | RVU26C |
| 2026-04-01 | $714.60 | $452.43 | RVU26B |
| 2026-01-01 | $714.60 | $452.43 | RVU26A |
| 2025-10-01 | $677.38 | $499.62 | RVU25D |
| 2025-07-01 | $677.38 | $499.62 | RVU25C |
| 2025-04-01 | $677.38 | $499.62 | RVU25B |
| 2025-01-01 | $677.38 | $499.62 | RVU25A |
| 2024-10-01 | $704.54 | $513.85 | RVU24D |
| 2024-07-01 | $704.54 | $513.85 | RVU24C |
| 2024-04-01 | $704.54 | $513.85 | RVU24B |
| 2024-03-09 | $704.54 | $513.85 | RVU24AR |
| 2024-01-01 | $693.04 | $505.46 | RVU24A |
| 2023-10-01 | $709.67 | $513.55 | RVU23D |
| 2023-07-01 | $709.67 | $513.55 | RVU23C |
| 2023-04-01 | $709.67 | $513.55 | RVU23B |
| 2023-01-01 | $709.67 | $513.55 | RVU23A |
| 2022-10-01 | $714.13 | $512.82 | RVU22D |
| 2022-07-01 | $714.13 | $512.82 | RVU22C |
| 2022-04-01 | $714.13 | $512.82 | RVU22B |
| 2022-01-01 | $714.13 | $512.82 | RVU22A |
| 2021-10-01 | $721.14 | $515.27 | RVU21D |
| 2021-07-01 | $721.14 | $515.27 | RVU21C |
| 2021-04-01 | $721.14 | $515.27 | RVU21B |
| 2021-01-01 | $721.14 | $515.27 | RVU21A |
| 2020-10-01 | $715.09 | $527.21 | RVU20D |
| 2020-07-01 | $715.09 | $527.21 | RVU20C |
| 2020-04-01 | $715.09 | $527.21 | RVU20B |
| 2020-01-01 | $715.09 | $527.21 | RVU20A |
| 2019-10-01 | $717.32 | $533.91 | RVU19D |
| 2019-07-01 | $717.32 | $533.91 | RVU19C |
| 2019-04-01 | $717.32 | $533.91 | RVU19B |
| 2019-01-01 | $717.32 | $533.91 | RVU19A |
| 2018-10-01 | $711.53 | $535.32 | RVU18D |
| 2018-07-01 | $711.53 | $535.32 | RVU18C |
| 2018-04-01 | $711.53 | $535.32 | RVU18B |
| 2018-01-01 | $711.53 | $535.32 | RVU18AR1 |
| 2017-10-01 | $701.43 | $529.80 | RVU17D |
| 2017-07-01 | $701.43 | $529.80 | RVU17C |
| 2017-04-01 | $701.43 | $529.80 | RVU17B |
| 2017-01-01 | $701.43 | $529.80 | RVU17A |
| 2016-10-01 | $698.05 | $527.38 | RVU16D |
| 2016-07-01 | $698.05 | $527.38 | RVU16C |
| 2016-04-01 | $698.05 | $527.38 | RVU16B |
| 2016-01-01 | $698.05 | $527.38 | RVU16A |
| 2015-10-01 | $699.82 | $528.20 | RVU15D |
| 2015-07-01 | $699.82 | $528.20 | RVU15C |
| 2015-04-01 | $696.34 | $525.57 | RVU15B |
| 2015-01-01 | $696.34 | $525.57 | RVU15A |
| 2014-10-01 | $723.79 | $555.90 | RVU14D |
| 2014-07-01 | $723.79 | $555.90 | RVU14C |
| 2014-04-01 | $723.79 | $555.90 | RVU14B |
| 2014-01-01 | $723.79 | $555.90 | RVU14A |
| 2013-10-01 | $728.67 | $550.40 | RVU13D |
| 2013-07-01 | $728.67 | $550.40 | RVU13C |
| 2013-04-01 | $728.67 | $550.40 | RVU13B |
| 2013-01-01 | $728.67 | $550.40 | RVU13AR |
Where the Utah rate applies
Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.
- Alpine
- Alta
- Altamont
- Alton
- Amalga
- American Fork
- Aneth
- Annabella
68320 billing questions
When should I report this instead of 68330?
Report 68320 when the reconstruction uses a conjunctival graft or extensive tissue rearrangement. Code 68330 is for conjunctivoplasty without a graft.
What operative details support 68320?
Document the affected conjunctival area, the graft or rearrangement performed, and the extent of the reconstruction. The record should make the method distinguishable from a procedure without grafting.
How does CMS treat bilateral reporting?
For a bilateral procedure reported with modifier 50, CMS pays 150%.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.
Does the surgical assistant receive payment?
CMS applies a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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