CPT code 68326: Fornix reconstruction, with mucous membrane graft2026 Medicare rate & RVUs in Michigan
Reconstructs a shortened or scarred conjunctival fornix using a mucous membrane graft, restoring the pocket beneath the eyelid.
CMS doesn’t publish an office rate for 68326 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 68326 covers
An ophthalmic surgeon reconstructs the conjunctival fornix when scarring or tissue loss has shortened the pocket between the eyelid and eye. The surgeon releases contracted tissue and places a mucous membrane graft to restore depth and lining. This may be needed after severe ocular surface inflammation, burns, or scarring associated with symblepharon; the operation is typically performed in a surgical setting.
Report this code when the operative work is fornix reconstruction with a mucous membrane graft, rather than a more limited conjunctival rearrangement or adhesion repair. The record should identify the affected fornix, the scarring or tissue loss, the graft used, and the reconstructive work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is 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.
Where 68326 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $558.53 |
| Rest of Michigan | Unavailable | $532.77 |
How the 68326 rate is calculated
Each of 68326’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 · 68326
RVUs × geographic indexes × conversion factor
Work8.21
8.21 RVUs× 1.000 GPCI
Practice expense7.65
7.65 RVUs× 1.000 GPCI
Malpractice0.67
0.67 RVUs× 1.000 GPCI
Adjusted RVUs
16.5300
Conversion factor
$33.4009
Medicare rate
$552.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 68326
68326 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68326
Fornix reconstruction, with mucous membrane graft
| 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) | 0 | Not permitted. |
| 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 · 68326
Fornix reconstruction, with mucous membrane graft
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
68326 without 50 · national facility
$552.12
Fornix reconstruction, with mucous membrane graft
68326-50 · Bilateral: 150%
$828.18
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).
68326 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 68325ConjunctivoplastyMucous membrane graft
- 68325 describes conjunctivoplasty with graft or extensive rearrangement. Choose 68326 when the operative objective is reconstruction of a shortened conjunctival fornix with a mucous membrane graft.
- 68330Symblepharon repairWithout graft
- 68330 is for symblepharon repair without a graft. This code involves fornix reconstruction using a mucous membrane graft.
- 68335Symblepharon repairWith graft
- 68335 describes symblepharon repair with a graft. Use this code when the documented service is reconstruction of the conjunctival fornix with a mucous membrane graft.
68326 billing questions
When should this be chosen over a conjunctivoplasty code?
Use this code when the operative goal is to restore a shortened conjunctival fornix with a mucous membrane graft. A conjunctivoplasty code describes a different pattern of conjunctival rearrangement or graft work.
How is this different from symblepharon repair with a graft?
This code describes reconstruction of the fornix with a mucous membrane graft. A symblepharon repair code is selected when the documented procedure is repair of the adhesion itself.
What documentation supports reporting this code?
Document the involved fornix, the scarring or tissue loss that limits its depth, use of a mucous membrane graft, and the reconstructive steps performed.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral surgery handled?
CMS lists this as a bilateral procedure; with modifier 50, payment is 150%.
Can an assistant, co-surgeon, or surgical team be paid?
Assistant-at-surgery payment is restricted for this code. 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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